INTRODUCTION:Anhidrotic ectodermal dysplasia is a rare disease combining hypodontia, hypotrichosis, and hypohidrosis. The quality of life is greatly impaired very early, with major difficulty for feeding and the drawbacks of usual dental prostheses. Early implant placement is a therapeutic alternative. It is usually performed in areas of stable growth, such as the mandibular symphysis. We report the case of very early implant placement in a child presenting with hypodontia related to ectodermal dysplasia. CASE PRESENTATION:A 6-year-old male patient was treated with maxillary and mandibular implant-borne prosthetic rehabilitation. Five implants were placed in the mandible and seven in the maxilla. The esthetic and functional outcome was satisfactory, improving the quality of life. DISCUSSION:Very early implant-borne prosthetic rehabilitation is an alternative, which could become a first line treatment. It restores oro-facial functions allowing for a better development of maxillo-facial bones. This alternative is not without risks. But is it acceptable to wait until teenage with an inadequate removable prosthesis, because growth is not completed?
The aim of this work is to review the relationship between the function of the masseter muscle and the occurrence of malocclusions. An analysis was made of the masseter muscle samples from subjects who underwent mandibular osteotomies. The size and proportion of type-II fibers (fast) decreases as facial height increases. Patients with mandibular asymmetry have more type-II fibers on the side of their deviation. The insulin-like growth factor and myostatin are expressed differently depending on the sex and fiber diameter. These differences in the distribution of fiber types and gene expression of this growth factor may be involved in long-term postoperative stability and require additional investigations. Muscle strength and bone length are two genetically determined factors in facial growth. Myosin 1H (MYOH1) is associated with prognathia in Caucasians. As future objectives, we propose to characterize genetic variations using "Genome Wide Association Studies" data and their relationships with malocclusions.
INTRODUCTION:Giant ameloblastomas are more common in developing countries. They raise a serious problem of management. We present the case of one of the largest ameloblastoma ever reported. CASE REPORT:A 48-year-old Congolese female patient was referred for mandibular swelling having begun 23 years before and now inducing severe functional disorders. A cephalic CT scan revealed a multicystic mass, 30×18×10cm in size, with a typical "soap bubble" presentation, and with thinned and inflated cortical bone. The treatment was sub-total segmental mandibulectomy with immediate reconstruction using a fibular free flap, modeled on the sampling site by four ostectomies. The pathological examination confirmed the diagnosis of a benign follicular and plexiform ameloblastoma. The excess of soft tissue was treated with a right commissuroplasty on the 15th postoperative day. There was no complication. DISCUSSION:Radical treatment followed by immediate reconstruction using a free flap is the treatment of choice for giant mandibular ameloblastomas, when considering immediate functional and esthetic benefits. This is a prime concern for patients with a difficult access to health care and for whom long-term follow-up is not feasible.
Botulinum toxin has a wide range of use in maxillo-facial surgery due to its action on muscles, on the glandular system, and against pain. It already has been given several market authorizations as indicated for: blepharospasm, spasmodic stiff neck, and glabellar lines. Furthermore, several studies are ongoing to prove its effectiveness and usefulness for many other pathologies: treatment of pain following cervical spine surgery; action on salivary glands after trauma, hypertrophy, or hyper-salivation; analgesic action (acknowledged but still being experimented) on neuralgia, articular pain, and keloids scars due to its anti-inflammatory properties. Botulinum toxin injections in the cervico-facial area are more and more used and should be to be correctly assessed. (c) 2013 Elsevier Masson SAS. All rights reserved.
INTRODUCTION:Odontogenic tumours are often benign. They are originating from dento-maxillary structures and their embryonic remnants. They represent a wide variety of lesions derived from epithelial cells, mesenchymal, or both. The series reported in literature show a distinct geographic variation. However, there has been no concrete study and detailed epidemiological profile of these tumours in the Algerian population. MATERIALS AND METHODS:Our prospective study based on the classification of the World Health Organization (WHO) in 2005, focused on the epidemiological analysis of 97 cases of odontogenic tumours, collected in the department of maxillofacial surgery of the University Hospital of Constantine. This study was designed to determine the relative frequency of such tumours, their distribution by age and sex, and their histological distribution. RESULT:In our series, women were most affected by the disease (64% of cases) than men (36% of cases). The population was predominantly young with an average age of 29.9 years (range from 12 to 85). The mandible was the site of choice in 74% of cases. Epithelial tumours were diagnosed in 77% of cases; almost half of these cases were ameloblastomas (44% of cases). DISCUSSION:The distribution of odontogenic tumours is different depending on the population studied. The incidence of ameloblastoma is increased in African and Asian population with a female predominance. On the other hand, the odontoma is the most recognized odontogenic tumour in North America and Europe, and more particularly in men.
Introduction. Dental pain is a frequent reason for consulting. It may have non-odontogenic causes such as lesions of vascular, neurologic, muscular, or bone structures. The diagnosis and management of this acute or chronic pain syndrome may be difficult. We report a case of atypical dental pain leading to the diagnosis of a plasmocytic mandibular tumor revealing a multiple myeloma.Case report. A 50-year-old female patient consulted for dental pain during the 3 previous months. Bilateral mandibular swelling was noted during the clinical examination. Radiological examinations revealed a tumoral process associated with osteolytic lesions. The pathological examinations of biopsy samples revealed plasmocytic proliferation. A myelogram and immunoglobulin electrophoresis supported a diagnosis of multiple myeloma with kappa light chains.Discussion. Discovering a mandibular tumor with lytic lesions is an indication for an etiological assessment and screening for a blood disease. A mandibular plasmacytoma may be isolated or present as a multiple myeloma, justifying a complete initial assessment. The bone localization of a plasmacytoma is a bad prognostic factor for survival for patients presenting with multiple myeloma. (c) 2013 Elsevier Masson SAS. All rights reserved.
INTRODUCTION:Trichoblastic carcinoma is a rare malignant adnexal tumor. Its presentation is non-specific and the diagnosis is always histological. CASE REPORT:A 56-year-old patient presented with a trichoblastic carcinoma of the eyelid and eyebrow. It was located on the lower end of the scar, 7 years after the incomplete excision of a tumor. There was a large subcutaneous extension of the tumor, well beyond the visible margins of the skin lesion. The treatment was a broad surgical excision followed by radiotherapy. There was neither local recurrence nor metastasis 20 months later. DISCUSSION:This clinical presentation was atypical and had never been reported. We discuss the therapeutic management of this rare tumor.
Purpose. We had for objective to assess odontogenic disorders associated to a congenital piriform aperture stenosis and to study their various presentations.Methods. Twelve patients presenting with a congenital piriform aperture stenosis, 1 week to 3 months of age, were retrospectively included from 1998 to 2008. All patients underwent an initial CT scan to evaluate the temporary dental germs.Results. Deciduous dental germs were abnormal in 75% of the cases. Thirty-three percent had a single median maxillary central incisor.Discussion. The concept of solitary median maxillary central incisor syndrome makes for a more pathophysiological approach of this type of disease, with various clinical presentations, corresponding to various levels of severity of a same pathological process. (c) 2013 Elsevier Masson SAS. All rights reserved.
