Luciano Catalfamo

Intraosseous mandibular artero-venous malformations: case report.

Intraosseous mandibular artero-venous malformations (AVMs) are rare (5% of all vascular malformations) but of great clinical importance. They can lead to dental emergencies and may cause disfigurement, morbidity, and even death. We describe the radiological appearance and the endovascular treatment of a rare high-flow vascular malformation of the mandibular body resembling a dental cyst, embolized by Guglielmis detachable coils (GDC).

Tongue schwannoma: clinicopathological findings.

Schwannomas are peripheral nerve sheath tumors. Approximately 25% of extracranial schwannomas are located in the head and neck district, but only 1% shows an intraoral origin. We report a case of a 28-year-old patient with a tongue schwannoma. Morphologic analysis and immunohistochemical findings strongly support the diagnosis. Surgical treatment is discussed.

Titanium miniplates: a new risk factor for the development of the bisphosphonate-related osteonecrosis of the jaw.

Abstract Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but potentially severe condition, and the etiopathology and risk factors are poorly defined. The American Association of Oral and Maxillofacial Surgeons position paper on BRONJ update 2009 remarks all the risk factors of developing BRONJ. Local anatomy such as lingual tori, mylohyoid ridge or palatal tori, and areas with thin mucosa overlying bony prominences represent some of these local factors. We have recently treated a patient presenting a mandibular osteonecrosis involving a rigid miniplate which had been placed 18 years ago during a surgical excision of a radicular cyst. The patient, a 70-year-old female, did not show any other risk factors which could expose her to BRONJ, such as cortisone therapy, head and neck radiotherapy, chemotherapy, periodontal disease, or other.

Complex Craniofacial Trauma Resulting From Fireworks Blast

The authors report the case of a patient who sustained a complex craniofacial trauma secondary to a recreational fireworks blast. Initial assessment and management were performed with a multidisciplinary approach to achieve control of cerebral hemorrhage, debridement of wounds and brain, isolation of the brain from the external environment, reconstruction of the cranial base floor, and orbital and facial reconstruction. Modification of multiple conventional approaches, along with a multispecialty surgical team, were used to deal effectively with this unusual patient who was treated by single-stage immediate management. Reconstruction of both the intracranial and extracranial compartments was considered successful with a satisfactory cosmetic result.

Effect of bisphosphonates on the mandibular bone and gingival epithelium of rats without tooth extraction

Osteonecrosis of the jaw (ONJ) is an adverse effect of bisphosphonate treatment that has become the subject of increasing investigations, in particular due to its poorly understood pathogenesis. Several experimental studies on animal models have been conducted; however, the majority of these replicate human ONJ following tooth extraction, and describe alterations in the bone and gingival epithelium when necrosis is manifested. The aim of the present study was to analyze the rat mandibular bone and gingival epithelium during 45 days of zoledronate treatment (which is a bisphosphonate agent), without tooth extraction. Intraperitoneal injections of zoledronate acid (0.1 mg/kg) were performed three times a week in normal male Wistar rats (n=20), while a control group of rats (n=20) was treated with saline solution for 45 days. After 7, 15, 30 and 45 days of drug treatment, all rats were sacrificed and hematoxilin and eosin staining, immunofluorescence and scanning electron microscopy analyses were performed. The results of the analyses after 7 and 15 days of treatment were similar in the treatment and control group. After 30 and 45 days of treatment, structural alterations were observed in the bone. No structural alterations to the gingival epithelium were observed. Based on these results, it was hypothesized that low doses of zoledronate act directly on the bone tissues to induce morphological alterations from bone to necrotic tissue following surgical procedures, although no cytotoxic effects were detected in the gingival epithelium.

Bioengineering in the oral cavity: our experience

Background To date, there are no studies reported in the literature on the possible use of bovine collagen, oxidized regenerated cellulose, or synthetic hyaluronic acid medications in the oral cavity. The aim of this paper is to report the use of bovine collagen, oxidized regenerated cellulose, and synthetic hyaluronic acid medications to improve wound healing in the oral cavity by stimulating granulomatous tissue. Methods From 2007 to 2011, 80 patients (median age 67 years) suffering from oral mucosal lesions participated in this double-blind study. The patients were divided into two groups, each consisting of 40 patients. One group received conventional medications, while the other group of patients were treated with the advanced medications. Results Advanced medications allowed re-epithelialization of the wound margin in 2–20 days, whereas patients receiving conventional medication showed a median healing duration of 45 days. Conclusion The results of this study demonstrate that treating oral mucosal wounds with advanced medication has an advantage with regard to wound healing time, allowing patients to have a rapid, functional, and esthetic recovery.

Tongue lymphangioma in adult.

Abstract Lymphangioma is a benign, hamartomatous tumor of the lymphatic channels. It is usually found in the head and neck region. Most lymphangiomas are present at birth and are usually diagnosed in infancy or early childhood. When lymphangioma occurs in the mouth, the anterior two thirds of the tongue is the most commonly affected region. A risk of secondary growth is classically described after surgical reduction. In this paper, we present 9 cases of tongue lymphangioma. We provide a literature review of tongue lymphangioma.

Traumatic Pseudoaneurysm of the Internal Maxillary Artery: A Rare Life-Threatening Hemorrhage as a Complication of Maxillofacial Fractures

Pseudoaneurysm of the internal maxillary artery due to a traumatic event is a rare condition. Pseudoaneurysms are usually directly produced by arteries break with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Then, this sac gradually expands and can be damaged. It is rare to see pseudoaneurysms of IMA. They are usually associated with fracture of the neck of the mandible. To the best of our knowledge the pseudoaneurysm of the internal maxillary artery related to maxillofacial trauma is an event extremely rare in the literature and if not quickly managed can lead to the patients death. This case underlines how the close cooperation between surgeons and radiologists results in a quick diagnosis and management of such pathological events.

Sarcoglycans and integrins in bisphosphonate treatment: immunohistochemical and scanning electron microscopy study.

Osteonecrosis of the jaw is an adverse outcome associated with bisphosphonate treatment. Bisphosphonates are used in conjunction with antineoplastic chemotherapy for the treatment of hypercalcaemia associated with malignancy, lytic bone metastasis and multiple myeloma. However, it is not known if the osteonecrosis of the jaw lesion originates in the bone or whether it initiates in the gingival epithelium. Two bisphosphonates are commonly used in cancer treatment. One of these is pamidronate disodium, a second-generation bisphosphonate that differs from the first-generation drug because it inhibits bone resorption at a dose that does not affect bone mineralization. The other widely used BP, zoledronate, is a third-generation drug that is the most potent bisphosphonate in clinical use, showing strong anti-osteoclastic activity, similar to pamidronate. The aim of the present study was to evaluate the modifications of human oral mucosa and underlying bone in patients after treatment with these nitrogen-containing bisphosphonates for 24 and 36 months. We analyzed the structural damage of the oral mucosa and damage of the perilesional mandibular bone observing possible correlations from them. Our results allow to express two hypotheses about the mechanism responsible for these results relating to mandible matrix necrosis; first, an increased skeletal microdamage associated with turnover suppression occurred early in treatment and progress with longer treatment duration, second, opening damage in osteonecrosis of the jaw modifies structural morphology of gingival epithelium.

Rhabdomyomas of the submandibular and sublingual glands.

Rhabdomyomas are rare benign mesenchymal tumors distinguished in cardiac and extracardiac forms. Extracardiac rhabdomyomas are classified as adult type, fetal type, and the genital type. Adult extracardiac rhabdomyomas are mostly found in the head and neck and usually present a slow growth. We report a case of a patient with a manifestation in the submandibular and sublingual glands.