Rudane E. Shultz

Treatment of a central arteriovenous malformation of the mandible with cyanoacrylate: A 4-year follow-up

Large arteriovenous malformations of the jaws are relatively rare, potentially life-threatening lesions. When the lesion is not suspected, extraction of teeth can be fatal. The occurrence and treatment of arteriovenous vascular communications in the head and neck region have traditionally presented most perplexing problems. Traditional treatment has usually involved the obtaining of proximal and distal vascular control and surgical removal of the lesions, when feasible. This article presents a case that is of particular interest because it illustrates the successful use of cyanoacrylate as the only treatment for a large arteriovenous malformation of the left side of the mandible. A 4-year follow-up shows no evidence of the lesion and demonstrates complete regeneration of bone in the same area.

Chronic pulmonary histoplasmosis with an oral lesion

Histoplasmosis is a fungal disease resulting from inhalation of airborne spores of the organism Histoplasma capsulatum. The disease is endemic to the Ohio and Mississippi river valleys. Oral lesions are not common, but when present, they are usually associated with the severe disseminated form of histoplasmosis. This particular case is presented as an example of chronic pulmonary histoplasmosis in which a localized gingival lesion represented the initial clinical manifestation of the disease. Diagnosis was based on a positive biopsy and the results of chest radiographic examination. If, as in this case, serologic, hematologic, and physical examination results are negative, the biopsy of suspicious lesions is of paramount importance to the clinical differential diagnosis.

Displacement of a root form implant into the mandibular canal.

An unusual complication associated with the placement of osseointegrated root form implants is presented. Discussion of this complication focuses on treatment planning and anatomic considerations in the posterior mandible that impact the viability of implant placement. Vital structures in this location, including the mandibular canal, are often obscured on routine panoramic radiography. Tomograms of the maxilla or mandible can provide data on cortical plate thickness, location of vital structures, and the presence of large medullary spaces, information that will decrease the incidence of implant complications.

Bilateral coronoid hyperplasia: Report of a case

A case of bilateral coronoid hyperplasia is presented. This is a developmental abnormality that occurs primarily in males and is characterized by progressive, asymptomatic limitation of mandibular movements. The condition is usually detected shortly after the age of puberty. A diagnosis is usually made on the basis of the history and the radiographic findings. Surgical removal of the elongated coronoid processes, along with good postoperative range-of-motion exercises, will restore full mandibular movement.

Herniation of the antral membrane through an extraction site: Report of a case

A case of herniation of the antral membrane through a recent extraction site is presented. The lesion was initially diagnosed as a tumor by the referring dentist. Oroantral fistulas are not an uncommon finding after dental extractions. It is rare, however, to see herniation of the antral membrane with large polyps extending through the fistula into the oral cavity. A search of the literature revealed only two other such cases. Surgical removal of the polyps and closure of the oroantral fistula by means of a buccal sliding flap technique is discussed.