Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumor that affects children and young adults. AFO occurs mainly intraosseous. Extraosseous AFO is extremely rare. We report two cases of rare peripheral ameloblastic fibro-odontoma in 2 and 12-year-old females. Microscopic examination revealed a benign proliferation of odontogenic epithelium associated with a dentinoid material distributed within a cell-rich mesenchymal stroma resembling dental papilla. Simple surgical excision of the lesion is usually curative.

To investigate the association of genic region polymorphisms of FAS and FASL in Indian oral cancer subjects.

Compare the outcome of surgical and conservative treatment approaches for medication-related osteonecrosis of the jaw.

To investigate the clinical manifestations and pathologic appearances of the submandibular gland (SMG) in Stevens-Johnson syndrome(SJS).

Hyperhomocysteinemia is a rare disease caused by nutritional deficiencies or genetic impairment of cysteine metabolism. To date, no oral manifestations of hyperhomocysteinemia has been described in humans. Therefore, the current case presents the first description of a hyperhomocysteinemic patient showing oral tissue alterations leading to both early tooth loss and failed implant osseointegration. The patient presented a methylenetetrahydrofolate reductase gene mutation (677T polymorphism) leading to a mild hyperhomocysteinemia.

To compare technical errors in bitewing radiographs acquired with round vs. rectangular collimation in a hospital based pediatric dentistry training program.

Lymphoproliferative disorders (LPD) are a group of conditions characterized by excessive production of lymphocytes manifested in various patterns including lymphadenopathy, tumor-like lesions, and lymphomas. LPD may be stimulated by Epstein Barr Virus (EBV) infection that most commonly appears in the setting of immunocompromised status such as long-term use of immunosuppressive medications and in Individuals with primary immunodeficiency disorders. EBV mucocutaneous ulcer (EBVMCU) is a benign LPD reaction that mostly regresses spontaneously while sometimes requires medical or surgical intervention.

Osteosarcoma is the most common primary malignancy of the jaws and is treated by radical surgical resection. Early detection is crucial since removing the lesion with clean margins contributes most to outcome. We present three cases of osteosarcoma occurring in the interradicular region of the mandible, two of which were thought to represent non-malignant processes upon initial presentation. All three demonstrated early but significant clinical and radiographic features indicative of the malignant disease process.

A 43-year-old man was referred to the oral medicine clinic of our university to evaluate an asymptomatic nodule of unknown duration on the upper lip. There was no history of trauma, alcoholism or smoking habits, and his medical history was noncontributory. Extraoral examination revealed no signs of asymmetry or lymphadenopathy or any skin color changes. An intraoral examination revealed a 1.0 cm solitary, submucosal, slightly mobile, nodule on the labial mucosa of the upper lip, consisting of a mass with a soft consistency on palpation, covered by intact and normal-colored mucosa (Fig.

On August 9th, 2021, Jay Inslee Governor for the state of Washington proclaimed that any health care worker who has not been FULLY vaccinated against COVID-19 will be prohibited from working after October 18th 20211. This decision was made following considerable discussion with over 60 medical groups including the American Medical Association, the American College of Physicians, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, together with the Society for Maternal-Fetal Medicine.

This study evaluated optimum stability of different screw techniques for condylar head fractures (P close to an M fracture with the lateral pole preserved according to AO classification 2014) by finite element analysis (FeA), and provided an bio-mechanical basis for clinical treatment.

The buccal myomucosal local flaps in oral cavity reconstruction can be considered a valid option for small-moderate defects. Nevertheless few articles report about functional recovery. The purpose of the present analysis is to evaluate the impact of these flaps on function and quality of life.

To evaluate the quality of information and readability of online content regarding medication-related osteonecrosis of the jaw (MRONJ).

To evaluate the reliability and long-term efficacy of the sternocleidomastoid (SCM) flap in reconstructing and repairing soft tissue defects after oral cancer surgeries.

To identify the incidence of inferior alveolar nerve injury following extraction of mandibular third molars with confirmed “high-risk” features on Cone-Beam Computed Topography scans and establish any risk factors which significantly increase the chances of sustaining an inferior alveolar nerve injury.

Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers worldwide traditionally occuring in older males with a known alcohol and tobacco history. Recently there has been a trend in the demographic shift to younger patients, aged 45 years or younger without significant history of known risk factors. Various studies suggest a possible genetic instability in addition to multifactorial risk factors involved in the pathogenesis of OSCC in young patients.1, 2,3,4 As evidenced by some studies, this increase in incidence may be even more significant in young female patients.

To assess characteristics of patients with mandibular osteoradionecrosis (ORN) of severity necessitating segmental mandibulectomy and osteocutaneous free flap reconstruction.

It has been well documented that the frequency of incidental findings in cone beam computed tomography (CBCT) scans is relatively high. These incidental findings range from low to high significance. Research has shown that many of these findings are not detected on 2D computed tomography or CBCT. CBCT scans vary from small to large field of view (FOV). One strategy to reduce the number of incidental findings and liability is to decrease the FOV.

The periosteum is a thin membrane that covers almost all bony surfaces in the human body. This membrane is attached to the underlying bone through type I collagen fibers known as Sharpey's fibers. The periosteum is organized into an inner cellular layer with significant osteoblastic potential and an outer fibrous layer. This osteoblastic potential can be stimulated by both physiologic processes in growth and fracture repair and by pathologic conditions. The characteristics of the periosteal responses are modulated by factors such as the type of initiating stimulus, age, and anatomic site.

The assessment of severity of medication-related osteonecrosis of the jaw (MRONJ) lesions is often complicated because the clinical presentation underrepresents the extent of the radiographically evident lesion. Thus, there is a critical need to identify and develop an objective radiographic staging of the MRONJ lesion to complement the clinical assessment. The composite radiographic index (CRI)1 is a meaningful index that attempts to convey the nature and extent of the radiographic changes. However, lesions that receive moderate scores using the CRI have a wide range of radiographic severity, undermining its clinical utility.

Viewing cone beam computed tomography (CBCT) scans at multiple locations and on multiple devices continues to present challenges. Several clinicians use smartphones to look at specific images for reference, especially intraoperatively. Currently, smartphone use is limited to viewing selected images or small videos at best. No applications were available until recently to view DICOM files on smartphones. The evolution of DICOM viewer apps for smartphones is a new feature. No studies currently exist that have tested the diagnostic efficacy of such platforms or their ease of use.

Regional odontodysplasia is a rare condition involving defective enamel and dentin in a group of adjacent teeth. It may also include calcifications within the dental pulp and/or dental follicle.1,2 First described by Hitchin in 1934,3 regional odontodysplasia affects dental mesodermal and ectodermal tissues along particular segments of the maxilla and/or mandible in the primary and/or permanent dentitions. There is a sex predilection, affecting women more than men.4 The current case is of a 6-year-old girl who presented with asymmetry of the face at a children's hospital in the eastern United States.

With a significant rise in the use of cone beam computed tomography (CBCT) and continuous evolution of newer applications, clinicians are increasingly using CBCT scans for bone density assessment using pixel intensity values (PIVs) while planning orthodontic treatment and in assessing fracture healing and dental implant sites. Several studies show that bone density increases with mandibular morphology and that patients with class III malocclusion have denser bone.

Pre-eruptive intracoronal resorption (PEIR) is a radiolucent lesion that affects the coronal dentin of unerupted teeth. PEIR is a rare condition with unknown cause, and it is usually detected incidentally in routine dental imaging. The radiographic appearance of PEIR resembles that of dental caries; however, some studies have reported clinical and histologic evidence to support the hypothesis that these lesions are likely resorptive in nature.

Many diseases and conditions can disrupt the normal function of the salivary glands, and imaging can be an important tool in the formulation of a diagnosis. With sialography being the imaging modality of choice for obstructive conditions of the major salivary glands, our group has previously demonstrated that cone beam computed tomography (CBCT) sialography offers enhanced visualization of inflammatory changes and obstructions, such as sialoliths and strictures, over plain film sialography.1 However, because ionizing radiation is a concern, optimizing imaging protocols is crucial in order to minimize the radiation dose to the patient while still producing images of high diagnostic quality.

Extensive fungal disease of the paranasal sinuses, an underrated entity that affects both immunocompromised and previously healthy patients, merits early diagnosis for effective diagnosis and treatment. Over the past few decades, the number of fungal infections in the sino-nasal tract has increased. The objective of this case report is to increase awareness of these conditions among dental professionals.

Neurofibromatosis type 1 (NF1) is an autosomal dominant, inherited, multisystemic disease caused by a mutation in the NF1 gene. A second mutation in this gene can lead to central giant cell granulomas (CGCGs) in the jaws of patients with NF1. In this case, we describe a patient with NF1 and the presence of a CGCG in the mandible.

Many disease processes are capable of producing an anterior mandibular swelling in young patients. Two pathologic entities with this presentation are the central giant cell lesion and the cemento-ossifying fibroma. Despite their vastly different histopathologic appearances, the radiographic features of these 2 entities may overlap, making radiologic interpretation between them challenging.

Fibromyxoma is a rare benign ectomesenchymal intraosseous tumor and is essentially a form of myxoma. The abundant collagen content in the lesion characterizes it as fibromyxoma. Myxomas can be found in many parts of the skeleton such as the extremities; however, this tumor is classified as odontogenic because of the existence of odontogenic epithelium. Histopathologically, fibromyxoma contains collagen with stellate and spindled-shaped cells floating in a mucoid intercellular matrix. This myxomatous matrix gives the lesion the ability to infiltrate marrow spaces.

Mucopolysaccharidosis (MPS) is an inherited metabolic disorder characterized by disturbances in degradation of glycosaminoglycans due to an enzyme deficiency. The accumulation and deposition of glycosaminoglycans leads to a progressive, multi-organ disorder that can result in death in the second decade of life. Nevertheless, there are patients with milder forms who have a relatively normal life expectancy. Patients with MPS may present with a wide range of characteristic craniofacial malformations.

Degenerative joint disease (DJD) is a noninflammatory arthritic condition. It occurs as a result of excessive forces that exceed the adaptive capacity of the joint. The etiology includes trauma, parafunctional habit, hypermobility of the joint, and/or internal derangement. Cone beam computed tomography (CBCT) plays a significant role in the evaluation of the osseous components of the temporomandibular joint (TMJ).

The Inferior alveolar nerve is the main nerve supply to the mandible, and its location and position related to the surrounding structures are critical during surgical procedures. The introduction of cone beam computed tomography (CBCT) with low radiation dose and high resolution has improved the anatomic visualization of the canal.

Exomass-related and motion artifacts are commonly observed in the everyday clinic and negatively affect cone beam computed tomography (CBCT) image quality. These 2 entities can be expected to occur in conjunction; however, they have only been assessed separately by the scientific community.

The presence of metal in the exomass (zone between the x-ray source and the image receptor) negatively affects image quality in cone beam computed tomography (CBCT), which cannot be effectively corrected by metal artifact reduction algorithms. However, considering that a metallic object can assume different positions in the exomass, the distance from the field of view (FOV) periphery could affect this condition.

Dentists rely on radiographs in making treatment decisions every day. However, if inattentively read, radiographs can lead to over- or undertreatment.

Schwannomas and neurofibromas are common benign neoplasms originating from the peripheral nerves. These neoplasms originating in the oral and para-oral tissues, especially involving the jaw, are extremely rare. Plexiform schwannoma is a unique variant in which the Schwann cells demonstrate a unique plexiform pattern. A literature search revealed only 2 case reports of plexiform schwannoma involving the jaws.

Skeletal complications and bone loss resulting from giant cell tumor (GCT) of the bone are uncommon.1 However, GCT can be locally aggressive and lead to surgical resection. Antiresorptive medications are used in these patients to reduce the risk of complications.

Vertebral nonsegmentation occurs because of segmentation failure of the vertebrae. The etiology of this failure can be congenital or acquired. The congenital nonsegmentation vertebrae may be partial or complete fusion at the body or the articular facets or in the transverse processes. The cervical vertebrae are the most commonly involved in the spine. These vertebrae are routinely visualized in cone beam computed tomography (CBCT), and the diagnosis is more precise in identifying nonsegmentation compared with the higher percentage of the false-positive findings on lateral cephalometric radiographs.

Colorectal cancer (CRC) is the third leading cause of cancer-associated deaths worldwide and is responsible for almost 9% of all deaths. Familial adenomatous polyposis (FAP) is an autosomal dominant disorder presenting with dento-osseous manifestations.

A pneumatocyst is an intraosseous gas collection. Although the etiology remains unclear, it has been associated with several conditions including osteomyelitis, trauma, osteonecrosis, and degenerative disease. They are uncommon lesions, with a reported rate varying from 0.13% to 3.9%. Pneumatocysts are more commonly seen in the sacroiliac joint and less commonly seen in the spinal vertebrae.

A small radiolucent lesion is challenging for radiologists to make an accurate diagnosis, especially if it is asymptomatic and an incidental finding. It could go under the umbrella of the odontogenic or nonodontogenic cyst or tumor. We present a well-defined, corticated, expansile, unilocular radiolucency in the ramus of the mandible at the mandibular foramen level that proved to be a simple bone cyst.

Diagnostic imaging is mandatory for the assessment of osseous defects in the jaws. Traditional imaging has offered much over the decades in the evaluation of these defects but is limited because of its 2D nature. The introduction of cone beam computed tomography (CBCT), a 3D radiographic technique with interactivity, high resolution, and high accuracy, has provided solutions in the evaluation of such lesions

With the current coronavirus disease pandemic, dental offices are trying their best to limit intraoral imaging. One solution to overcome this problem is to use extraoral imaging techniques.

Silent sinus syndrome (SSS) is familiar to otolaryngologists and ophthalmologists but is a rare clinical entity in dentistry and likely to be underdiagnosed because of lack of awareness. It presents a diagnostic challenge to dentists because patients typically have no history of trauma or sinusitis. The exact pathophysiology of SSS is still debated. Here we report 3 cases of SSS in adults.

The implementation of preventive strategies has aided in the noticeable decline of caries prevalence in developed countries. With the reduction of caries prevalence, there is a higher demand for more sensitive and accurate caries detection modalities. In this study we explore the utility of stationary intraoral tomosynthesis (sIOT) in occlusal caries detection.

Dentigerous cysts are common benign odontogenic cysts.1 A dentigerous cyst is characterized by an epithelium attachment that is associated with the crown of an unerupted tooth and appears radiographically as a well-defined radiolucency.2,3 The dentigerous cyst may be a cholesterol granuloma histopathologically when it is associated with numerous cholesterol clefts with foam cells, foreign body giant cells, and macrophages filled with hemosiderin.4 Cholesterol granuloma often occurs in the middle ear and may be found in other sites.

The hybrid central giant cell granuloma/central odontogenic fibroma-like (hCGCG/COF) lesion was first described in 1992 and has been reported fewer than 50 times thereafter. Separately, central giant cell granulomas (CGCG) and central odontogenic fibromas (COF) account for approximately 5% and 10% of all benign jaw tumors, respectively. Published literature reveals that the clinical, radiologic, and histologic features of hCGCG/COF lesions share similar characteristics with both entities in varying degrees; however, the precise nature of the lesions remains unclear.