A Giant Osteoma of the Mandible

An osteoma is a benign, slow growing osteogenic tumor characterized by proliferation of either compact or cancellous bone. It can be central, peripheral or extraskeletal. Clinically osteomas are usually asymptomatic. These lesions often go undetected unless incidentally found on radiographic survey or until they have extended to such an extent that they cause facial asymmetry or functional impairment. The most common site of osteoma to develop in maxillofacial region is skull. Giant osteomas in mandible are rare. We present and discuss a case of giant osteoma of right mandible which was surgically excised.     

Uncommon peripheral osteoma of the mandible: report of two cases

The osteoma is a benign osteogenic neoplasm of bone. Peripheral osteoma of the mandible is uncommon. It is often asymptomatic and usually discovered when a patient complains of esthetic problems and presents for treatment. Peripheral osteomas have a characteristic clinical and radiographic appearance, but their pathogenesis is obscure. Described here are two patients with peripheral osteoma of the mandible, which might occur as a result of a combination of trauma and muscle traction.     

Osteoblastoma of the maxilla and mandible: a report of 24 cases, review of the literature, and discussion of its relationship to osteoid osteoma of the jaws

Osteoblastoma is a benign neoplasm of bone characterized by a proliferation of osteoblasts forming bone trabeculae set in a vascularized fibrous connective tissue stroma. We report 24 examples of this neoplasm arising in the maxilla and mandible and compare the clinical and radiographic characteristics of this neoplasm to 53 previously reported examples of osteoblastoma and osteoid osteoma in the jaws. Our results reveal more females reported in the new examples of osteoblastoma than in the previously reported examples of osteoblastoma and osteoid osteoma. This raises the overall female percentage from 47.2% to 58.4%. In addition, significantly fewer patients reported pain, tenderness, and discomfort associated with their neoplasms than in previously reported cases. When all cases are combined, a predominant trend is observed whereby osteoblastoma occurs predominantly on the left side of the posterior mandible and is associated with pain, tenderness, and discomfort. We also provide a rationale for use of the term "osteoblastoma" for any benign osteoblastic neoplasm arising in the jaws.     

An unusual tonsillolith

A case of a large tonsillolith of the left palatine is presented. The lesion was detected incidentally during radiographic examination of a patient presenting with right mandibular pericoronitis. The patient had no symptoms referable to the left tonsillar region. Superimposition of the tonsillolith on the left mandibular ramus on panoramic radiographic examination created the false impression of an intraosseous radiopaque lesion. Many radiopaque structures and lesions occur in the soft tissues close to the jaws and are often observed on panoramic radiographs produced by imaging units with broad focal troughs. Such radiopacities in the mandibular molar-ramus region include sialolith, phlebolith, cysticercosis and calcified lymph node, carotid artery arteriosclerosis, stylohyoid ligament mineralization, and dystrophic calcification in acne scars. Tonsilloliths may present on panoramic radiograph as radiopaque objects superimposed on the midportion of the ascending mandibular ramus, and may be initially misinterpreted as intraosseous lesions of the mandible, such as foreign body, odontoma, sclerosing osteitis, Garre osteomyelitis, fibrous dysplasia, idiopathic osteosclerosis, and osteoma.     

Sclerotic mandibular bone lesion.

A case of a sclerotic mandibular bone lesion interpreted as a true osteoma has been described, along with the differential diagnosis and treatment. Because the radiographic appearance is not specific for any one lesion, microscopic examination is essential to establish the definitive diagnosis.     

Clinical and radiologic behaviour of ameloblastoma in 4 cases

Ameloblastoma is a benign but locally aggressive epithelial odontogenic neoplasm. It represents 1% of all tumours of the jaw bone. In 80% of cases, it is localized in the mandibular molar and ascending ramus area, mostly associated with an unerupted tooth. It occurs over a wide range of ages (mean age is in the 20s or 30s) and with equal frequency in men and women. Ameloblastoma may be discovered during a routine radiographic examination or as a clinically observed developing mass. It has a characteristic, but not diagnostic, radiographic appearance. It can be treated by enucleation, bone curettage or wide resection. The rate of local recurrence is high when it is treated inadequately. We describe the clinical and radiologic behaviour of ameloblastoma and discuss treatment protocols and the possibility of conservative management of this tumour. Our results suggest the importance of long-term follow-up with various radiographic techniques.     

Myxoma of the mandible with unusual radiographic appearance

Myxoma of the jaws is a fairly frequent bone tumor classified as a benign odontogenic neoplasm. The radiographic picture varies according to its evolution and, it many cases, diagnosis is not easy. A new case with an unusual radiographic appearance is reported. On occlusal radiographic examination the tumor showed multiple spicules of bone with a classic "sun-ray" effect. Only two similar cases were found in the literature. Oral and maxillofacial surgeons should be aware of this unusual presentation so that a misdiagnosis of malignant bone tumor is not made.     

Osteoma of the mandible: case report and application of multi-detector-row CT rendering technique

Osteoma is an uncommon benign slow growing neoplasm of the bone, characterized by proliferation of osteoblasts forming bone trabeculas in a connective tissue stroma. After paranasal sinus, mandible is its second most frequent location. The osteoma can be central, peripheral or of extraskeletal type. Peripheral osteomas are quite uncommon. This fact suggests that peripheral osteoma of the mandible may be traumatically damaged, mostly because of muscle traction. This paper reports a case of peripheral osteoma located in the mandible. The patient underwent a multi-detector-row computed tomography (MDCT) in order to plan corrective surgery. MDCT images were post-processed with volume rendering techniques.     

Ethmoid sinus osteoma associated with blow-out fracture

Osteoma is a benign tumor that is composed of compact or cancellous bone. It is the most common benign neoplasm of the paranasal sinus, and ethmoid sinuses are the second most common sites of paranasal sinus osteoma. The symptoms of ethmoid sinus osteoma can give rise to various kinds and extent of symptoms. In symptomatic cases, surgical management is necessary, but appropriate surgical approach to the ethmoid sinus is not clearly established. We describe 2 male patients with a diagnosis of blow-out fractures after trauma; ethmoid sinus osteoma on preoperative computed tomography scans was coincidentally found, and the surgical correction was done simultaneously. The purpose of this article was to present the successful surgical removal of ethmoid osteoma through lamina papyracea and transcaruncular approach, resulting in both successful surgical correction and good cosmetic outcome.     

Unusual cone-beam computerized tomography presentation of traumatic (simple) bone cyst: case report and radiographic analysis

Traumatic (simple) bone cyst (TBC) is an empty nonepithelial-lined cavity of the jaws. The majority of TBCs are located in the body or symphysis of the mandible. Clinically, the lesion is asymptomatic and often discovered incidentally on routine radiographic examination as a noncorticated sharply defined radiolucent area with undulating borders. Because tissues for histologic examination may be scant or nonexistent, the definite diagnosis is invariably achieved during surgery when the lesion is empty. In this report, we present a case of unusual bilateral synchronous TBCs of the mandible with possible traumatic etiology, featuring significant buccolingual expansion of the mandibular ramus and body, presence of septa, and probable displacement of the inferior alveolar canal.     

Peripheral osteoma of the oral and maxillofacial region: a study of 35 new cases.

PURPOSE: The purpose of this article was to present 35 new cases of peripheral osteoma of the oral and maxillofacial region with an analysis of the literature. PATIENTS AND METHODS: We performed a search of our files for the past 5 years for peripheral osteoma of the oral and maxillofacial region. The criteria used to diagnose osteoma included the radiographic and histologic features. RESULTS: The 35 patients, which included 23 males (65%) and 12 females (35%), ranged in age from 14 to 58 years, with a mean age of 29.4 years. Most of the osteomas were located in frontal bone (28.57%), mandible (22.85%), and maxilla (14.28%). CONCLUSION: Peripheral osteomas of the jaw bones are uncommon, and accordingly, patients with osteoma should be evaluated for Gardner's syndrome. In addition, it is appropriate to provide both clinical and radiographic follow-up after surgical excision of a peripheral osteoma.     

Peripheral Osteoma of the Body of Mandible: A Case Report

Osteoma is a slow growing benign tumor consisting of well differentiated compact or cancellous bone that increases in size by continuous growth. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in mandible. Although completely curable with adequate surgical treatment, osteomas precede the clinical radiographic evidence of colonic polyposis/Gardner’s syndrome. Therefore they may be sensitive markers for the disease. Recurrence of peripheral osteoma after surgical excision is extremely rare. However it is appropriate to provide both clinical and radiographic follow up after surgical excision of peripheral osteoma. This article describes the case of a 45 year old male who presented with painless swelling of the right body of mandible and resultant cosmetic facial disfigurement and functional impairment.     

Supernumerary premolars associated with dens evaginatus: report of 2 cases

Dens evaginatus is a dental anomaly found predominantly in people of Mongoloid origin. Dentists practising in Western countries should also be aware of this condition because of the increasing migration of people from Asia. Supernumerary premolars are uncommon but may be found incidentally during radiographic examination of teeth with dens evaginatus. This article reports 2 cases of concomitant occurrence of supernumerary premolars and dens evaginatus. The presence of a supernumerary premolar in 1 quadrant is an indication for radiographic examination of all other premolar regions.     

Peripheral ivory osteoma of the mandible in a young female patient

Osteoma is an uncommon benign neoplasm composed of mature bone. Growth is slow and continuous and located principally in the cranio‐maxillo‐facial region, and can be central (endosteal) or peripheral (periosteal). Osteomas can be solitary or multiple masses, and they are generally asymptomatic. We discuss a case of ivory osteoma of the mandible in a 35‐year‐old female, which was present at the left body of the mandible since she was 10 years old, and was gradually increasing in size. The osteoma was removed surgically through an intraoral approach, and no recurrence was observed.     

Central osteoma of the maxilla with involvement of paranasal sinus

Osteoma is an osteoblastic benign tumor characterized by the proliferation of either compact or cancellous bone. In the jaws, the most of cases reported in the literature presented as peripheral solitary lesions, involving preferably the posterior region of the mandible. However, central osteomas are quite rare, especially in the maxillary bone. The purpose of this article was to present the clinical, radiographic, surgical, and histologic features of a solitary central osteoma of the maxilla with involvement of the paranasal sinus and to review the literature for central osteomas located in the jaws. Our clinical report participates to literature as the 12th case of central osteoma in the jaws and the fourth case in the maxillary bone.     

Bilateral tonsilloliths in a 77-year-old white man with edentulous jaws: a case report

Concretions in the tonsils are uncommon, and well-formed tonsilloliths are extremely rare. We describe a case of bilateral tonsilloliths in an edentulous 77-year-old white man. The lesions were detected incidentally during a radiographic examination. Since radiography often does not clearly distinguish tonsilloliths from other radiopaque lesions of the jaws, we used computed tomography to establish an accurate diagnosis.     

Osteochondroma of the mandibular condyle: literature review and report of a case

AIM: The intent of this report is to present a brief review of the literature on osteochondroma and to present a case involving the surgical removal and replacement of a major portion of the condyle and angle of the mandible using free autogenous mandibular bone. BACKGROUND: While osteochondroma is the most common tumor of skeletal bones, it is relatively uncommon in the jaws occurring at the condyle or the tip of the coronoid process. This benign cartilage-capped growth is usually discovered incidentally on radiographic examination or on palpation of a protruding mass in the affected area. Malocclusion and progressive facial asymmetry are common findings in most cases of condylar osteochondroma. REPORT: A case of a 29-year-old woman with an osteochondroma of the mandibular condyle is presented. Surgical treatment was tumor resection, grafting, and reshaping of the mandibular angle and ramus. As this lesion is usually asymptomatic and discovered incidentally on radiographic examination, the general practitioner usually is the first professional to make the diagnosis. SUMMARY: Condylectomy cannot be recommended as routine in all cases.37 Common surgical treatments include condylectomy and reconstruction.24 If the tumor involves only a limited area of the condylar surface, then preservation of the remaining portion of the condyle and reshaping should be done. Reasons for not taking such a conservative approach are the possibilities of malignancy and the risk of recurrence. In this case report the extraoral vertical ramus osteotomy, associated with free autogenous mandibular bone, presented several advantages.     

Osteoid osteoma of the zygoma: report of an unusual case

BACKGROUND: Osteoid osteoma is a benign tumor of bone characterized by pain, usually occurring at night, that shows a dramatic response to aspirin. The literature contains reports of only a few cases in the head and neck region. CASE DESCRIPTION: The authors present an unusual case of an osteoid osteoma of the craniofacial bones. The patient sought an evaluation of pain in the area of the right zygoma. One of the authors, an oral and maxillofacial surgeon, noted a small area of swelling. The patient underwent radiographic, computed tomographic and nuclear medicine studies. On the basis of the images and the biopsy report, the authors made a diagnosis of osteoid osteoma. In this article, they describe the treatment of and new modalities of therapy for this condition. CLINICAL IMPLICATIONS: The general dentist should be aware of any lesion that is not common. If the generalist has any doubt about the nature or management of an unusual oral lesion, referral to appropriate specialists is mandatory.     

Peripheral osteoma of the mandible: case report and review of the literature.

BACKGROUND: Osteoma is a benign often asymptomatic neoplasm, consisting of well-differentiated mature bone. This paper reports a case of peripheral osteoma located in the anterior mandibular region and provides a review of the literature about this lesion in the jaws. PATIENT AND METHODS: A 43-year-old white woman presented with a swelling in the left mandible of 7 years duration. The English literature was reviewed over the past 76 years and data about location, histopathology and number of the peripheral osteomas, sex, and age of the patients were evaluated. RESULTS: Data analysis showed 69 well-documented cases of peripheral osteoma. Peripheral osteomas are more frequent in the mandible than the maxilla and the cancellous type was most frequent; males and females are equally affected in the mandible; the age range was 9-85 years. CONCLUSION: The peripheral type of osteoma is most common in the lower jaws, occurs at the surface of the cortical bone and is sessile or pedicled.     

Idiopathic osteosclerosis in the mandible associated with abnormal tooth root formation

Idiopathic osteosclerosis (IO) is a localized, well-defined, intrabony radiopaque lesion within cancellous bone. The causes of IO are still unknown and most lesions are nonexpansile and asymptomatic, so they are often detected incidentally on radiographic examination for other purposes. In the case of jaw lesions, IO is considered to be of no clinical significance and usually requires no treatment. This paper describes two clinical cases about the long-term treatments and observations of mandibular IO in adolescents. The lesions were associated with abnormal tooth root formation and tooth malposition. In these cases, the orthodontic treatments finished successfully without any complication despite the lesions. IO in the jaw needs regular follow-up to ensure normal orofacial development during adolescence.