Pub Date : 2026-03-01Epub Date: 2025-12-08DOI: 10.1016/j.omsc.2025.100430
Mohammed H. Albodbaij, Mohammed I. Albokhamseen, Bander Y. Alkarri
Macroglossia, or an abnormally large tongue, can appear in either a relative or a true form, and it is frequently linked to a specific syndrome. Enlargement may occur due to vascular malformations or stem from the expansion of muscles. Congenital macroglossia (present from birth) is rare, reported in fewer than 5 in every 100,000 live births. The condition associated with Down's syndrome is typically relative macroglossia, while true macroglossia is most commonly seen in individuals with Beckwith-Wiedemann syndrome. The recommended treatment for true macroglossia is a partial glossectomy to help secure the airway and prevent malocclusions. Herein, we describe the treatment of a patient presenting with the rare association of a pathogenic, de novo DEAF1 variant and macroglossia. Diagnosis was confirmed via whole-exome sequencing, and imaging and histopathology suggested underlying muscular hypertrophy. The patient underwent partial glossectomy using the keyhole technique. Postoperative follow-up was uneventful for eighteen months, with objective measurements confirming sustained reduction in tongue size and functional improvement. To our knowledge, this is the first reported association between a DEAF1 mutation and congenital macroglossia.
{"title":"Deformed epidermal autoregulatory factor 1(DEAF 1) mutation-associated Macroglossia: A rare case report","authors":"Mohammed H. Albodbaij, Mohammed I. Albokhamseen, Bander Y. Alkarri","doi":"10.1016/j.omsc.2025.100430","DOIUrl":"10.1016/j.omsc.2025.100430","url":null,"abstract":"<div><div>Macroglossia, or an abnormally large tongue, can appear in either a relative or a true form, and it is frequently linked to a specific syndrome. Enlargement may occur due to vascular malformations or stem from the expansion of muscles. Congenital macroglossia (present from birth) is rare, reported in fewer than 5 in every 100,000 live births. The condition associated with Down's syndrome is typically relative macroglossia, while true macroglossia is most commonly seen in individuals with Beckwith-Wiedemann syndrome. The recommended treatment for true macroglossia is a partial glossectomy to help secure the airway and prevent malocclusions. Herein, we describe the treatment of a patient presenting with the rare association of a pathogenic, de novo DEAF1 variant and macroglossia. Diagnosis was confirmed via whole-exome sequencing, and imaging and histopathology suggested underlying muscular hypertrophy. The patient underwent partial glossectomy using the keyhole technique. Postoperative follow-up was uneventful for eighteen months, with objective measurements confirming sustained reduction in tongue size and functional improvement. To our knowledge, this is the first reported association between a DEAF1 mutation and congenital macroglossia.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"12 1","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-01DOI: 10.1016/j.omsc.2026.100440
María Gabriela Nassif , Facundo Zamar , Lucas Ritacco , Juan José Larrañaga , Marcelo Figari , Federico Garola
Background
Odontogenic keratocysts (OKCs) are benign lesions with aggressive biological behavior and high recurrence rates, particularly when involving anatomically complex regions such as the mandibular condyle and adjacent skull base structures. In these settings, repeated conservative approaches often fail, while radical resection poses major functional and esthetic challenges.
Case presentation
Two patients with recurrent, aggressive mandibular OKC involving the condylar, pterygoid, and zygomatic regions were treated by en bloc resection followed by computer-assisted total temporomandibular joint replacement (TMJ-TJR). Virtual surgical planning based on fused CT–MRI datasets and intraoperative navigation were used to guide both resection and reconstruction. Reconstruction was performed using patient-specific prostheses incorporating a hybrid basket-type mandibular component designed to accommodate an autologous iliac crest bone graft.
Results
Complete removal of the affected hard and soft tissues was achieved in both cases. At long-term follow-up (7 and 9 years), no evidence of recurrence was observed. Both patients demonstrated stable occlusion, satisfactory facial symmetry, and adequate mandibular function.
Conclusion
In carefully selected cases of recurrent OKC involving the condylar region, computer-assisted TMJ-TJR using a hybrid basket-type mandibular component may represent a viable reconstructive option, enabling radical disease control while restoring mandibular form and function in anatomically challenging scenarios.
{"title":"Computer-assisted total temporomandibular joint replacement with a hybrid basket-type mandibular component in recurrent mandibular keratocysts: Report of two cases","authors":"María Gabriela Nassif , Facundo Zamar , Lucas Ritacco , Juan José Larrañaga , Marcelo Figari , Federico Garola","doi":"10.1016/j.omsc.2026.100440","DOIUrl":"10.1016/j.omsc.2026.100440","url":null,"abstract":"<div><h3>Background</h3><div>Odontogenic keratocysts (OKCs) are benign lesions with aggressive biological behavior and high recurrence rates, particularly when involving anatomically complex regions such as the mandibular condyle and adjacent skull base structures. In these settings, repeated conservative approaches often fail, while radical resection poses major functional and esthetic challenges.</div></div><div><h3>Case presentation</h3><div>Two patients with recurrent, aggressive mandibular OKC involving the condylar, pterygoid, and zygomatic regions were treated by en bloc resection followed by computer-assisted total temporomandibular joint replacement (TMJ-TJR). Virtual surgical planning based on fused CT–MRI datasets and intraoperative navigation were used to guide both resection and reconstruction. Reconstruction was performed using patient-specific prostheses incorporating a hybrid basket-type mandibular component designed to accommodate an autologous iliac crest bone graft.</div></div><div><h3>Results</h3><div>Complete removal of the affected hard and soft tissues was achieved in both cases. At long-term follow-up (7 and 9 years), no evidence of recurrence was observed. Both patients demonstrated stable occlusion, satisfactory facial symmetry, and adequate mandibular function.</div></div><div><h3>Conclusion</h3><div>In carefully selected cases of recurrent OKC involving the condylar region, computer-assisted TMJ-TJR using a hybrid basket-type mandibular component may represent a viable reconstructive option, enabling radical disease control while restoring mandibular form and function in anatomically challenging scenarios.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"12 1","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2025-12-25DOI: 10.1016/j.omsc.2025.100433
Raghad Eid, Eiad Khouri, Nadim Sleman
Background
The orbital floor represents a complex challenge in facial trauma, often requiring reconstruction using materials that provide a stable base and restore the correct orbital volume.
Purpose
The aim of this study is to evaluate the efficacy of a novel flexible β-TCP plate in orbital floor reconstruction, focusing on anatomical restoration, functional outcomes, and safety profiles.
Methods
A prospective clinical study of 10 patients (8 males, 2 females; aged 20–70 years) with orbital floor fractures was conducted. Treatment involved surgical reconstruction using β-TCP plates. Preoperative assessment included CT imaging and ophthalmologic evaluation (visual acuity, forced duction test). β-TCP plates were applied via a subciliary approach to reconstruct the orbital floor. Clinical and radiological evaluations were performed at 15 days, 1, 3, and 6 months postoperatively.
Results
Anatomical outcomes showed complete enophthalmos resolution in 80 % of cases (8/10), with minor residual enophthalmos in 30 % (3/10). Functional recovery was excellent, with diplopia resolving in all cases (9/9) and unrestricted ocular motility achieved in 100 % of patients. The procedure was safe, with no infections, implant migrations, or extrusions observed. Radiologic integration was confirmed by stable graft positioning on CT scans during follow-up.
Conclusion
The flexible β-TCP plate demonstrates excellent efficacy in orbital floor reconstruction, with high rates of functional recovery and minimal complications. Its adaptability and biocompatibility support its use as a viable alternative to traditional materials. Larger studies with extended follow-up are warranted to validate long-term outcomes.
{"title":"Assessment of flexible β-TCP plates in orbital floor fracture management: A prospective clinical and Radiographic study","authors":"Raghad Eid, Eiad Khouri, Nadim Sleman","doi":"10.1016/j.omsc.2025.100433","DOIUrl":"10.1016/j.omsc.2025.100433","url":null,"abstract":"<div><h3>Background</h3><div>The orbital floor represents a complex challenge in facial trauma, often requiring reconstruction using materials that provide a stable base and restore the correct orbital volume.</div></div><div><h3>Purpose</h3><div>The aim of this study is to evaluate the efficacy of a novel flexible β-TCP plate in orbital floor reconstruction, focusing on anatomical restoration, functional outcomes, and safety profiles.</div></div><div><h3>Methods</h3><div>A prospective clinical study of 10 patients (8 males, 2 females; aged 20–70 years) with orbital floor fractures was conducted. Treatment involved surgical reconstruction using β-TCP plates. Preoperative assessment included CT imaging and ophthalmologic evaluation (visual acuity, forced duction test). β-TCP plates were applied via a subciliary approach to reconstruct the orbital floor. Clinical and radiological evaluations were performed at 15 days, 1, 3, and 6 months postoperatively.</div></div><div><h3>Results</h3><div>Anatomical outcomes showed complete enophthalmos resolution in 80 % of cases (8/10), with minor residual enophthalmos in 30 % (3/10). Functional recovery was excellent, with diplopia resolving in all cases (9/9) and unrestricted ocular motility achieved in 100 % of patients. The procedure was safe, with no infections, implant migrations, or extrusions observed. Radiologic integration was confirmed by stable graft positioning on CT scans during follow-up.</div></div><div><h3>Conclusion</h3><div>The flexible β-TCP plate demonstrates excellent efficacy in orbital floor reconstruction, with high rates of functional recovery and minimal complications. Its adaptability and biocompatibility support its use as a viable alternative to traditional materials. Larger studies with extended follow-up are warranted to validate long-term outcomes.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"12 1","pages":"Article 100433"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.omsc.2026.100441
Sandra Regina Guimarães , André Pereira Falcão , Aline do Nascimento Pires , Luiz Bianchi , Rodrigo Camargo Soares Figueiredo , Bruno Ynuie de Jesus , Ronald Alejandro Zegarra , Luiz Carlos Magno Filho
Temporomandibular joint ankylosis (TMJA) is debilitating condition characterized by fibrous or bony fusion of the disc-condyle complex to the temporal articular surface. In growing patients, this condition disrupts mandibular development and leads to severe dentofacial deformities and functional impairment. This case report describes the management of a 14-year-old female with recurrent TMJA and severe mandibular asymmetry after costochondral grafting performed at age six. Virtual surgical planning, bimaxillary orthognathic surgery, and unilateral customized total TMJ replacement were used in a single-stage protocol. At the 2-year follow-up, the patient demonstrated a stable increase in maximum mouth opening, improved occlusion, and enhanced facial symmetry without relapse. This case highlights the feasibility of alloplastic TMJ prostheses as a reconstructive option in select pediatric patient with recurrent ankylosis. Management of childhood TMJA is complex and requires extensive and rigorous planning; a customized TMJ prosthesis may represent a viable and safe option to improve clinical parameters in young patients.
{"title":"Temporomandibular joint ankylosis relapse in childhood: Functional and skeletal correction using a customized total TMJ prosthesis and orthognathic surgery—A 2-year follow-up case report","authors":"Sandra Regina Guimarães , André Pereira Falcão , Aline do Nascimento Pires , Luiz Bianchi , Rodrigo Camargo Soares Figueiredo , Bruno Ynuie de Jesus , Ronald Alejandro Zegarra , Luiz Carlos Magno Filho","doi":"10.1016/j.omsc.2026.100441","DOIUrl":"10.1016/j.omsc.2026.100441","url":null,"abstract":"<div><div>Temporomandibular joint ankylosis (TMJA) is debilitating condition characterized by fibrous or bony fusion of the disc-condyle complex to the temporal articular surface. In growing patients, this condition disrupts mandibular development and leads to severe dentofacial deformities and functional impairment. This case report describes the management of a 14-year-old female with recurrent TMJA and severe mandibular asymmetry after costochondral grafting performed at age six. Virtual surgical planning, bimaxillary orthognathic surgery, and unilateral customized total TMJ replacement were used in a single-stage protocol. At the 2-year follow-up, the patient demonstrated a stable increase in maximum mouth opening, improved occlusion, and enhanced facial symmetry without relapse. This case highlights the feasibility of alloplastic TMJ prostheses as a reconstructive option in select pediatric patient with recurrent ankylosis. Management of childhood TMJA is complex and requires extensive and rigorous planning; a customized TMJ prosthesis may represent a viable and safe option to improve clinical parameters in young patients.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"12 1","pages":"Article 100441"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-08-24DOI: 10.1016/j.omsc.2025.100418
Tariq Wahass , Khalid Almutairi , Fares Alrawashedah , Mohammed Assiri , Ali Almontashari
Surgically assisted rapid palatal expansion (SARPE) is generally safe, with rare major complications. We report a unique case of a 22-year-old woman with a history of meningomyelocele who developed pneumocephalus and cerebrospinal fluid (CSF) rhinorrhea six days after SARPE with pterygomaxillary disjunction. Imaging revealed a skull base fracture at the roof of the right sphenoid sinus and bilateral ossified pterygospinous ligaments, which may have redirected osteotomy forces to the cranial base. The patient presented with positional headaches and clear nasal discharge, and CSF leakage was confirmed by MRI. She was successfully managed with conservative treatment, including bed rest, head elevation, and antibiotics. This case highlights the importance of recognizing anatomical variations that may predispose patients to skull base injury during SARPE and stresses the need for prompt evaluation of symptoms like rhinorrhea and headache. Early diagnosis and non-surgical management can lead to favorable outcomes, even in the presence of complex skull base fractures.
{"title":"Cranial base fracture associated with pneumocephalus and cerebrospinal fluid leakage following surgically-assisted rapid maxillary expansion: A case report","authors":"Tariq Wahass , Khalid Almutairi , Fares Alrawashedah , Mohammed Assiri , Ali Almontashari","doi":"10.1016/j.omsc.2025.100418","DOIUrl":"10.1016/j.omsc.2025.100418","url":null,"abstract":"<div><div>Surgically assisted rapid palatal expansion (SARPE) is generally safe, with rare major complications. We report a unique case of a 22-year-old woman with a history of meningomyelocele who developed pneumocephalus and cerebrospinal fluid (CSF) rhinorrhea six days after SARPE with pterygomaxillary disjunction. Imaging revealed a skull base fracture at the roof of the right sphenoid sinus and bilateral ossified pterygospinous ligaments, which may have redirected osteotomy forces to the cranial base. The patient presented with positional headaches and clear nasal discharge, and CSF leakage was confirmed by MRI. She was successfully managed with conservative treatment, including bed rest, head elevation, and antibiotics. This case highlights the importance of recognizing anatomical variations that may predispose patients to skull base injury during SARPE and stresses the need for prompt evaluation of symptoms like rhinorrhea and headache. Early diagnosis and non-surgical management can lead to favorable outcomes, even in the presence of complex skull base fractures.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spindle cell lipoma (SCL) is a subtype of lipoma classified by Enzinger et al. in 1975. It is a benign tumor commonly found in the subcutaneous tissue of the shoulder, back, and posterior neck in middle-aged men. This report describes a rare case of low-fat type SCL in the pterygomandibular space. A 33-year-old man was referred to the department for further examination and treatment of a radiolucent area of the left mandibular ramus incidentally detected on a panoramic radiograph taken by a general dentist. Computed tomography and magnetic resonance imaging showed a 50 mm mass with apparent continuity with the inferior alveolar neurovascular bundle in the pterygomandibular space. An incisional biopsy prompted a provisional diagnosis of neurofibroma, and the whole tumor was excised under general anesthesia. Histopathologically, the tumor was found to consist of spindle-shaped cells, adipocytes, and collagen fibers, resulting in a final diagnosis of SCL. There has been no evidence of recurrence more than 5 years postoperatively.
{"title":"Spindle cell lipoma in the pterygomandibular space: A case report","authors":"Natsumi Takamaru , Naoyuki Fukuda , Kazuya Akita , Yukihiro Nogami , Takaaki Tsunematsu , Naito Kurio","doi":"10.1016/j.omsc.2025.100420","DOIUrl":"10.1016/j.omsc.2025.100420","url":null,"abstract":"<div><div>Spindle cell lipoma (SCL) is a subtype of lipoma classified by Enzinger et al. in 1975. It is a benign tumor commonly found in the subcutaneous tissue of the shoulder, back, and posterior neck in middle-aged men. This report describes a rare case of low-fat type SCL in the pterygomandibular space. A 33-year-old man was referred to the department for further examination and treatment of a radiolucent area of the left mandibular ramus incidentally detected on a panoramic radiograph taken by a general dentist. Computed tomography and magnetic resonance imaging showed a 50 mm mass with apparent continuity with the inferior alveolar neurovascular bundle in the pterygomandibular space. An incisional biopsy prompted a provisional diagnosis of neurofibroma, and the whole tumor was excised under general anesthesia. Histopathologically, the tumor was found to consist of spindle-shaped cells, adipocytes, and collagen fibers, resulting in a final diagnosis of SCL. There has been no evidence of recurrence more than 5 years postoperatively.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100420"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-08-27DOI: 10.1016/j.omsc.2025.100419
A. Mentone , E. Esposito , M. Funaro , A. Santorelli
Auricular anomalies can present a wide spectrum, ranging from mild deformities to severe malformations that not only impact the ear's shape but may also impair auditory function. These conditions often lead to emotional challenges and self-esteem issues in affected patients. Numerous otological abnormalities have been anatomically classified, prompting the development of various corrective techniques. Approaches to treating auricular malformations range from traditional and more invasive methods, often associated with higher patient morbidity, to newer and minimally invasive otoplasty techniques introduced in recent years. Recognizing the need to provide patients with a definitive solution while minimizing the complications linked to conventional otoplasty, we propose a novel technique called “Preservation Otoplasty.”
{"title":"Preservation otoplasty","authors":"A. Mentone , E. Esposito , M. Funaro , A. Santorelli","doi":"10.1016/j.omsc.2025.100419","DOIUrl":"10.1016/j.omsc.2025.100419","url":null,"abstract":"<div><div>Auricular anomalies can present a wide spectrum, ranging from mild deformities to severe malformations that not only impact the ear's shape but may also impair auditory function. These conditions often lead to emotional challenges and self-esteem issues in affected patients. Numerous otological abnormalities have been anatomically classified, prompting the development of various corrective techniques. Approaches to treating auricular malformations range from traditional and more invasive methods, often associated with higher patient morbidity, to newer and minimally invasive otoplasty techniques introduced in recent years. Recognizing the need to provide patients with a definitive solution while minimizing the complications linked to conventional otoplasty, we propose a novel technique called “Preservation Otoplasty.”</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100419"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-31DOI: 10.1016/j.omsc.2025.100425
Dana C. Jackson, Nnamdi Anosike, Flora Elena Sarmiento
Idiopathic bone cavity (IBC) is a bony lesion of undefined etiology or pathogenesis. It usually presents as a benign, slowly growing and painless lesion that is often discovered by dental providers during routine panoramic radiographic examination. The etiology is unclear, and this uncertainty has left surgeons without standard diagnostic criteria and treatment modalities, especially for large or extensive cases. In this article, we report a case of managing an extensive recurrent bilateral idiopathic bone cavity of the mandible with surgical debridement and curettage with the use of platelet rich plasma. The retreatment option discusses the use of a viable Cellular Bone Matrix (VivoGen) combined with platelet rich plasma (PRP) following debridement and curettage. The patient showed continuous mandibular bone growth and regeneration both clinically and radiographically after a year of follow up.
{"title":"Management of a recurrent, expansile idiopathic bone cavity of the mandible with cellular bone matrix (VivoGen) and platelet rich plasma: A case report","authors":"Dana C. Jackson, Nnamdi Anosike, Flora Elena Sarmiento","doi":"10.1016/j.omsc.2025.100425","DOIUrl":"10.1016/j.omsc.2025.100425","url":null,"abstract":"<div><div>Idiopathic bone cavity (IBC) is a bony lesion of undefined etiology or pathogenesis. It usually presents as a benign, slowly growing and painless lesion that is often discovered by dental providers during routine panoramic radiographic examination. The etiology is unclear, and this uncertainty has left surgeons without standard diagnostic criteria and treatment modalities, especially for large or extensive cases. In this article, we report a case of managing an extensive recurrent bilateral idiopathic bone cavity of the mandible with surgical debridement and curettage with the use of platelet rich plasma. The retreatment option discusses the use of a viable Cellular Bone Matrix (VivoGen) combined with platelet rich plasma (PRP) following debridement and curettage. The patient showed continuous mandibular bone growth and regeneration both clinically and radiographically after a year of follow up.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100425"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The danger triangle of the face has a unique and highly vascularized anatomy, and therefore infections in this area pose a significant risk for fulminant spread.
Case presentation
A 30-year-old man presented himself with right facial swelling due to a subcutaneous pustule in the right beard area, outside of the danger triangle of the face. From here, the infection was able to spread to the orbital area and structures of the central nervous systems through the valveless facial vein. Here the infection caused permanent vision loss to the right eye as a result of the damage, together with intraventricular pus, causing loss of neurological function. Despite adequate efforts for source control, the infection could not be contained and caused pulmonary infectious bilateral empyema and pulmonary abscesses. Although the patient reported feeling better, imaging studies of the brain continued to show progressive lesions, such as watershed infarctions and possible secondary infection of these lesions. After two months of treatment, the patient's health was deemed sufficient to be transferred to a specialized rehabilitation center to try and recover the neurological functions lost.
Conclusion
Early identification and intervention in facial infections are vital to prevent complications, underscoring the need for clinician awareness. Source control and prevention of spread of the infection after identification are crucial for optimal patient outcomes.
{"title":"Beyond the danger triangle, the fulminant course of a facial infection: A case report","authors":"Haya H.R. Al-Bayyati , Jesse Brinkman , Arnaud F.K. D'Heygere , Leander Dubois","doi":"10.1016/j.omsc.2025.100426","DOIUrl":"10.1016/j.omsc.2025.100426","url":null,"abstract":"<div><h3>Introduction</h3><div>The danger triangle of the face has a unique and highly vascularized anatomy, and therefore infections in this area pose a significant risk for fulminant spread.</div></div><div><h3>Case presentation</h3><div>A 30-year-old man presented himself with right facial swelling due to a subcutaneous pustule in the right beard area, outside of the danger triangle of the face. From here, the infection was able to spread to the orbital area and structures of the central nervous systems through the valveless facial vein. Here the infection caused permanent vision loss to the right eye as a result of the damage, together with intraventricular pus, causing loss of neurological function. Despite adequate efforts for source control, the infection could not be contained and caused pulmonary infectious bilateral empyema and pulmonary abscesses. Although the patient reported feeling better, imaging studies of the brain continued to show progressive lesions, such as watershed infarctions and possible secondary infection of these lesions. After two months of treatment, the patient's health was deemed sufficient to be transferred to a specialized rehabilitation center to try and recover the neurological functions lost.</div></div><div><h3>Conclusion</h3><div>Early identification and intervention in facial infections are vital to prevent complications, underscoring the need for clinician awareness. Source control and prevention of spread of the infection after identification are crucial for optimal patient outcomes.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100426"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-31DOI: 10.1016/j.omsc.2025.100424
Carson Van Etta, Connor Witty
A 27-year-old male presented to our outpatient clinic with right-sided facial asymmetry, describing significant difficulty wearing his respiratory protection mask system for his military occupation. Radiographic imaging revealed a right-sided expansile maxillary lesion—5.5 cm in largest dimension— occupying and narrowing most of the maxillary sinus with a ground-glass appearance. Clinical history, radiographic characteristics and examination of the lesion suggested a likely diagnosis of fibrous dysplasia, which was later confirmed histologically and genetically. A Tecnetium-99 bone scan subsequently ruled out a polyostotic form of fibrous dysplasia, noting only significant radiotracer uptake within the right maxilla. In this report, operative management of fibrous dysplasia is discussed along with a novel technique for surgical contouring— utilizing virtual surgical planning with a depth-drill guide mirroring the unaffected anatomy on the left side.
{"title":"A novel technique to treat maxillary monostotic fibrous dysplasia","authors":"Carson Van Etta, Connor Witty","doi":"10.1016/j.omsc.2025.100424","DOIUrl":"10.1016/j.omsc.2025.100424","url":null,"abstract":"<div><div>A 27-year-old male presented to our outpatient clinic with right-sided facial asymmetry, describing significant difficulty wearing his respiratory protection mask system for his military occupation. Radiographic imaging revealed a right-sided expansile maxillary lesion—5.5 cm in largest dimension— occupying and narrowing most of the maxillary sinus with a ground-glass appearance. Clinical history, radiographic characteristics and examination of the lesion suggested a likely diagnosis of fibrous dysplasia, which was later confirmed histologically and genetically. A Tecnetium-99 bone scan subsequently ruled out a polyostotic form of fibrous dysplasia, noting only significant radiotracer uptake within the right maxilla. In this report, operative management of fibrous dysplasia is discussed along with a novel technique for surgical contouring— utilizing virtual surgical planning with a depth-drill guide mirroring the unaffected anatomy on the left side.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100424"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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