Brown tumor of the mandible associated with secondary hyperparathyroidism: a case report and review of the literature

Brown tumors are rare lesions that can develop in persistent cases of hyperparathyroidism (HPT). Therefore, identification of these lesions by diagnostic imaging is important during the follow-up of patients with HPT. This report describes a 45-year-old woman who developed HPT-induced brown tumors that appeared initially as an oral lesion. The diagnosis, treatment, and control of the disease--as well as the histopathological characteristics--are emphasized.     

Brown tumor in the palate associated with primary hyperparathyroidism

A case of brown tumor on the hard palate associated with primary hyperparathyroidism is reported. The diagnosis was suggested by the oral findings and clinical history and confirmed by biochemical determinations. Excision of a parathyroid adenoma normalized the metabolic situation and at a one-year follow-up the palatal tumor had diminished in size and lamina dura was partially regenerated.     

Brown tumors associated with secondary hyperparathyroidism of chronic renal failure.

Two cases of brown tumors associated with secondary hyperparathyroidism and chronic renal failure are reported. Both patients underwent excision of the tumor because of mechanical interference. Subsequent parathyroidectomy has substantially improved the general status of the patients.     

Brown tumor in children with normocalcemic hyperparathyroidism: a report of two cases

Brown tumor is an important sign of a number of metabolic bone diseases. Normocalcemic hyperparathyroidism, a rare childhood pathologic finding, reveals itself with brown tumors as the only initial sign. In this study, two cases of normocalcemic hyperparathyroidism accompanied by mandibular brown tumors are presented.     

Brown tumor of the mandible as first manifestation of primary hyperparathyroidism: diagnosis and treatment

Brown tumor is one of the lesions that develop in patients with hyperparathyroidism. Any of the skeletal bones can be affected including the cranio-maxillofacial ones. Most of the times the brown tumor appears after a final diagnosis of hyperparathyroidism is made. However brown tumor can be the first clinical sign of the disease. A clinical case in which a brown tumor located in the anterior part of the mandible appears as the first sign of primary hyperparathyroidism is presented. The possible differential clinical diagnosis and the recommended treatments are revised.     

Brown tumor of the jaws as a manifestation of tertiary hyperparathyroidism: A literature review and case report

Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant‐cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand‐wrist, pelvis, and femur. We present here a brief literature review focusing on the clinical and radiographic features, diagnostic criteria and treatment of brown tumor and also report a case of the disease affecting the jaw.     

Diagnosis of a maxillary brown tumor associated with hyperparathyroidism secondary to chronic renal failure--a case report

Brown tumor associated with hyperparathyroidism secondary to chronic renal failure has been increasingly documented of late. This intraosseous giant cell lesion is indistinguishable from a central giant cell granuloma and is considered as an unusual local complication of renal osteodystrophy. This report presents a case of a maxillary brown tumor in an uremic, non-hemodialysis patient with secondary hyperparathyroidism. The radiographic, biochemical, and histopathological examinations are reported and the possible pathogenesis is also discussed.     

Giant cell lesion associated with secondary hyperparathyroidism: case report

A child with a giant cell lesion (brown tumor) associated with secondary hyperparathyroidism due to chronic renal failure was reported. The patient presented at age 6 years, 5 months with swelling in the right mandible that was biopsied and diagnosed histologically as a giant cell lesion. The patient received a successful kidney transplant 8 months later and the giant cell lesion resolved during the 17 months following the operation.     

肿瘤术后颌骨功能重建的长期效果观察

本主要探討利用腓骨血管瓣合併人工植體立即種植的方式,以期待恢復病患外觀及口腔咀嚼功能的前提下,對過去（1993～迄今）間的手術技術的改進及長期追蹤的結果作報告。利用腓骨血管皮瓣做顎骨重建面臨三大問題：1.腓骨重建成的下顎骨,由於其高度與正常下顎骨高度有落差,     

Stylohyoid syndrome: surgical approach

The best-known cervicopharyngeal pain is Eagle syndrome, in which symptomatic elongation of the stylomandibular process occurs and may be accompanied by stylohyoid ligament calcification. Among the causes of elongation of the styloid process, the following may be mentioned: history of trauma, styloid ligament calcification, and formation of bony tissue in the insertion of the styloid ligament. When there is no history of trauma or surgery, it is called the stylohyoid syndrome. In the current study, the clinical case of 34-year-old woman is reported, complaining of pain in the region of the neck, without any history of neck surgery or trauma. A panoramic radiograph and computed tomographic scan showed bilateral elongation of the styloid process. Extraoral surgical intervention was the treatment of choice. It is important to point out that dentists should be aware of this condition to contribute to a better diagnosis and therapeutic procedure.     

Interproximal papilla augmentation procedure: a novel surgical approach and clinical evaluation of 10 consecutive procedures.

Periodontal plastic surgery enables enhanced esthetics in the anterior maxillary region. Reconstruction of the interdental papilla is one of the most challenging and least predictable of treatments. Several surgical and nonsurgical procedures to rebuild lost papillae have been presented; however, good results have been elusive. The purpose of the present study was to evaluate a novel surgical procedure based on an advanced papillary flap combined with a gingival graft intended to augment the soft tissue in the interdental area. The study comprised 10 consecutive papilla augmentation procedures performed in nine patients. Previous to the surgical procedure and at least 3 months postoperative, papilla contour measurements were carried out based on a papilla index score (PIS). PIS ranged from 0 to 2 preoperative (mean 1.0) and between 1 and 3 postoperative (mean 2.2). In eight procedures, PIS increased. Differences between pre- and postoperative PIS ranged from 0 to 3 PIS units (mean 1.2). Among the 10 procedures, there was an increase of 1 PIS unit in five, an increase of 2 PIS units in two, 3 PIS units in one, and no increase in the remaining two. This procedure is relatively easy to perform and offers a reliable solution to an esthetic problem. However, larger clinical and histologic follow-up studies are necessary before its long-term predictability can be established.     

The effect of secondary hyperparathyroidism and hemodialysis therapy on alveolar bone and periodontium

BACKGROUND: Alveolar bone is particularly sensitive to increased levels of parathyroid hormone (PTH) from either primary or secondary hyperparathyroidism (HPT). The purpose of this study was to examine the effect of secondary HPT on the periodontium of patients on hemodialysis. METHODS: The experimental group consisted of 35 patients with secondary HPT, with chronic renal failure treated by hemodialysis (E group). A control group (C group) was formed from 35 healthy age- and gender-matched subjects attending the maxillofacial outpatient clinic for a variety of reasons. Blood samples were taken from the E group, and the biologically active intact parathormone molecule, PTH(1-84), was assayed using two-site immunoradiometric assay (IRMA). The time of onset and the duration since diagnosis of HPT was also recorded. In addition, for a subgroup of 25 matched pairs of patients, a clinical periodontal examination was performed, and the Ramfjord index teeth were recorded for: Plaque index (PI); Gingival index (GI); Probing depth (PD); and Clinical attachment level (CAL). A standardized panoramic X-ray was taken from all patients and computer-based linear measurements were used to assess alveolar bone loss (BL). Unpaired Student's t-test served to compare the two groups. Pearson's correlation coefficient test was used to study the association between PI, PTH level, disease duration and BL. RESULTS: Demographically, both groups were similar with no statistical difference. PI was also similar in the C and E group (2.03 +/- 0.13 and 1.76 +/- 0.17, respectively). GI, however, was slightly greater in the C group (1.28 +/- 0.09) compared to the E group (0.97 +/- 0.01). PD in the E group (2.92 +/- 0.14 mm) was almost identical to that of the C group (2.90 +/- 0.12 mm). Likewise, CAL in the E group (4.43 +/- 0.29 mm) did not differ from CAL in the C group (4.03 +/- 0.25 mm). Mean BL was also similar in the E and C groups (3.60 +/- 0.23 mm and 3.85 +/- 0.24 mm, respectively). PI showed a positive, significant correlation with BL (r = 0.457, P = 0.0008). CONCLUSION: From this study it can be concluded that secondary HPT does not have an appreciable effect on periodontal indices and radiographic bone height.     

A minimally invasive surgical approach for periodontal regeneration: surgical technique and observations

Increasingly, patients referred to periodontists have undergone some form of non-surgical periodontal treatment prior to their referral. As a result of this, there is an increased need to treat isolated, rather than generalized, periodontal defects. A surgical technique that utilizes small incisions and a limited access approach for treating isolated periodontal defects is described. Results from the use of the minimally invasive surgical (MIS) technique for periodontal regeneration in a comparison study appear to be similar to those where a more traditional surgical approach has been used. Some of the apparent advantages and disadvantages of using the MIS approach are discussed.