Kyste osseux anévrismal de la mandibule

The aneurysmal bone cyst is a rare, expansive, osteolytic, pseudocystic lesion with an unknown etiology. It usually affects long bones and the spine. Two to 5 % of cases have mandibular localization (between 75 and 100 % present on the mandible) accounting for 1 % of all mandibular cysts. Less than 200 cases have been reported in English and French literature.     

Adénome pléomorphe géant de la parotide

Introduction

Slow evolution pleomorphic parotid adenoma may be diagnosed late. These giant tumors have a functional, esthetic, and social impact. They raise prognostic issues because of the risk of degeneration. We present a case of a giant pleomorphic adenoma involving the parotid glands and try to explain the reasons for the diagnostic delay and describe therapeutic specificities.

Case report

A 54 year-old male patient consulted for swelling of the parotid region slowly evolving over the last 10 years. This lesion had been unsuccessfully treated by conventional methods. A painless 20 cm long plurinodular mass was located in the right lateral cervical region. Its consistence was heterogeneous. The CT scan revealed a heterogeneous tumor with hyperdense and hypodense areas without any associate lesions. A total conservative parotidectomy was performed; the anatomopathological examination confirmed the diagnosis of a pleomorphic adenoma, weighing 1.2 kg for a diameter of 19 cm, without malignant degeneration. The postoperative evolution was uneventful.

Discussion

The recommended treatment for giant parotid adenoma is total conservative parotidectomy. Besides its functional and esthetic impact, the giant parotid adenoma is at high risk of malignant degeneration. Documentation on the nature of the lesion, its evolutive potential, and an early surgical management could limit its incidence.     

Chirurgie endoscopique d’un fibro-odontome améloblastique mandibulaire

Introduction

Ameloblastic fibro-odontoma is a rare mixed odontogenic tumor. It occurs predominantly in children and young adults. This article reports a case of ameloblastic fibro-odontoma affecting a young boy who was treated by endoscopy.

Case report

An 11-month-old child was admitted for a right mandibular rapidly growing mass. Computed tomography confirmed the presence of a large radiopaque mass on the right mandible containing compartmented tooth-germs. A biopsy exeresis was performed to completely remove the tumor with an endonasal endoscope. The histological diagnosis was an ameloblastic fibro-odontoma.

Discussion

We performed the enucleation with a nasal endoscope to make sure that the entire lesion had been removed. Bone resection was minimal which should decrease the risk of growth disorders. The ameloblastic fibro-odontoma is a rare mixed odontogenic tumor usually asymptomatic and slow growing. Histopathology proves the diagnosis. The treatment is curettage, preserving the adjacent teeth.     

Autologous tissue engineering by means of distraction osteogenesis: Biomechanical considerations

Tissue engineering consists in producing functional replacement tissue. Distraction osteogenesis is a tissue engineering technique that uses the mechanical environment of cells to induce tissue regeneration, without need for exogenous biochemical factors. A better understanding of the optimal mechanical conditions of distraction callus stretching may reduce the duration, discomfort, and even social impact of distraction protocols, and complications and failures. We present the current state of knowledge in this field by addressing the fundamentals of elongating bone tissue biomechanics, the influence of rhythm and rate of distraction, and that of vectors and stability. Finally, we present the innovations currently studied, which may modify our clinical protocol in the short term.     

Third molar and mandibular canal: selection of radiographic techniques

Injury of the inferior alveolar nerve during extraction of mandibular third molar is a well recognized, but uncommon, serious complication. It has a serious impact on oral function and its psychological impact on the patient is great. To prevent this complication, several studies have been conducted to identify the high-risk radiological signs associated with intimate anatomic relationships between third molar and infra-alveolar nerve and thereby establish a unified process of radiological exploration. In this paper, the authors present a review of the literature of the recent studies involving radiological exploration of the relation of the third molar with the mandibular canal.