Pub Date : 2025-12-01Epub Date: 2025-09-11DOI: 10.1016/j.omsc.2025.100423
Mohamad A. Alhomsi, Issa B. Wehbeh
Background
A beautiful smile is a key element of facial aesthetics, with an average gingival display of 1–3 mm in smile position. When gingival visibility exceeds this range, it is defined as a gummy smile. This condition may result from skeletal, dentoalveolar, or soft tissue factors.
Case description
Three patients with mild gummy smile were treated using different approaches: (i) traditional lip repositioning surgery, (ii) modified lip repositioning surgery, and (iii) Botox injection. Patients were monitored for two weeks to assess postoperative complications. Follow-up evaluations at two weeks, one month, three months, and six months assessed gingival exposure and relapse.
Conclusion
The modified lip repositioning procedure demonstrated greater stability between the three- and six-month follow-ups, with the least relapse, although it was associated with more postoperative complications. Botox was the most preferred option due to its non-invasive nature.
{"title":"Evaluation of the efficacy of three distinct lip repositioning techniques and identification of the approach associated with the lowest relapse rate. A six-month follow-up case report","authors":"Mohamad A. Alhomsi, Issa B. Wehbeh","doi":"10.1016/j.omsc.2025.100423","DOIUrl":"10.1016/j.omsc.2025.100423","url":null,"abstract":"<div><h3>Background</h3><div>A beautiful smile is a key element of facial aesthetics, with an average gingival display of 1–3 mm in smile position. When gingival visibility exceeds this range, it is defined as a gummy smile. This condition may result from skeletal, dentoalveolar, or soft tissue factors.</div></div><div><h3>Case description</h3><div>Three patients with mild gummy smile were treated using different approaches: (i) traditional lip repositioning surgery, (ii) modified lip repositioning surgery, and (iii) Botox injection. Patients were monitored for two weeks to assess postoperative complications. Follow-up evaluations at two weeks, one month, three months, and six months assessed gingival exposure and relapse.</div></div><div><h3>Conclusion</h3><div>The modified lip repositioning procedure demonstrated greater stability between the three- and six-month follow-ups, with the least relapse, although it was associated with more postoperative complications. Botox was the most preferred option due to its non-invasive nature.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057328","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: 2025-09-11DOI: 10.1016/j.omsc.2025.100422
Rémy Raphael , Dimitri Pascual
Introduction
The full-arch rehabilitation of the atrophic maxilla using four zygomatic implants (ZI) has become a widespread solution, allowing us to bypass bone grafting procedures. However, the palatal prosthetic emergences inherent to the skeletal discrepancy cause significant discomfort for patients due to prosthetic compensations volume.
Observation
A 60-year-old patient, completely edentulous at the maxillary with severe atrophy and a skeletal Class III, was referred to us for full rehabilitation. We use an innovant surgical guide to perform the Le Fort I osteotomy, placement of four zygomatic implants, and immediate loading of a screw-retained Zirconia bridge without prosthetic compensation in one single surgery virtually planned.
Conclusion
Zygomatic implant and orthognathic rehabilitation, using a custom surgical guide, offers an accurate solution to restore in a single surgery, the oral function with an immediate loading prothesis when the maxilla atrophy is severe in skeletal Class III.
使用四个颧植入物（ZI）对萎缩的上颌骨进行全弓康复已经成为一种广泛的解决方案，使我们能够绕过植骨手术。然而，由于假体代偿体积的差异，腭假体出现固有的骨骼差异会给患者带来明显的不适。一位60岁的患者，上颌完全无牙，严重萎缩，骨骼为III级，被转介到我们进行完全康复。我们使用一种创新的手术指南，在一次手术中完成Le Fort I型截骨术，放置四个颧骨植入物，并立即加载螺钉保留的氧化锆桥，而无需假体补偿。结论颧骨种植和正颌康复，采用定制的手术指导，可以在颌骨严重萎缩的情况下，单次手术修复即刻加载假体的口腔功能。
{"title":"Rehabilitation of the atrophic maxilla: Guided Le Fort I maxillary advancement and zygomatic implants with and immediate loading","authors":"Rémy Raphael , Dimitri Pascual","doi":"10.1016/j.omsc.2025.100422","DOIUrl":"10.1016/j.omsc.2025.100422","url":null,"abstract":"<div><h3>Introduction</h3><div>The full-arch rehabilitation of the atrophic maxilla using four zygomatic implants (ZI) has become a widespread solution, allowing us to bypass bone grafting procedures. However, the palatal prosthetic emergences inherent to the skeletal discrepancy cause significant discomfort for patients due to prosthetic compensations volume.</div></div><div><h3>Observation</h3><div>A 60-year-old patient, completely edentulous at the maxillary with severe atrophy and a skeletal Class III, was referred to us for full rehabilitation. We use an innovant surgical guide to perform the Le Fort I osteotomy, placement of four zygomatic implants, and immediate loading of a screw-retained Zirconia bridge without prosthetic compensation in one single surgery virtually planned.</div></div><div><h3>Conclusion</h3><div>Zygomatic implant and orthognathic rehabilitation, using a custom surgical guide, offers an accurate solution to restore in a single surgery, the oral function with an immediate loading prothesis when the maxilla atrophy is severe in skeletal Class III.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100422"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220631","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 : 2025-09-01Epub Date: 2025-07-12DOI: 10.1016/j.omsc.2025.100412
Hassan El-Awour , Kinda Allaham , Mohammed Inam Ullah Khan
Here we present a case of Angina Bullosa Hemorrhagica (ABH) and review the literature highlighting its features, differentiation diagnosis from similar lesions, management considerations, and treatment options. Furthermore, we present a treatment algorithm for managing cases of this rare disorder. ABH lesions commonly manifest on the palate, tongue, buccal mucosa, lips, the floor of the mouth, and uvula. ABH range in size, from 4 to 30 mm in diameter. ABH lesions are generally self-limiting and resolve within a few days without scarring. Management recommendations may include supportive therapy for small lesions, incision for large bulla and continued palliative therapy using mouthrinses and analgesics. Though, ABH is a rare disorder, general dental practitioners ought to be aware of it. This report provides guidance on diagnosis, management and investigations in hopes to avoid ill-informed or unnecessary treatments.
{"title":"Angina bullosa hemorrhagica: A case report and review of the literature","authors":"Hassan El-Awour , Kinda Allaham , Mohammed Inam Ullah Khan","doi":"10.1016/j.omsc.2025.100412","DOIUrl":"10.1016/j.omsc.2025.100412","url":null,"abstract":"<div><div>Here we present a case of Angina Bullosa Hemorrhagica (ABH) and review the literature highlighting its features, differentiation diagnosis from similar lesions, management considerations, and treatment options. Furthermore, we present a treatment algorithm for managing cases of this rare disorder. ABH lesions commonly manifest on the palate, tongue, buccal mucosa, lips, the floor of the mouth, and uvula. ABH range in size, from 4 to 30 mm in diameter. ABH lesions are generally self-limiting and resolve within a few days without scarring. Management recommendations may include supportive therapy for small lesions, incision for large bulla and continued palliative therapy using mouthrinses and analgesics. Though, ABH is a rare disorder, general dental practitioners ought to be aware of it. This report provides guidance on diagnosis, management and investigations in hopes to avoid ill-informed or unnecessary treatments.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864701","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}
Bifid mandibular condyle (BMC) is a rare developmental or acquired anomaly of the temporomandibular joint (TMJ), characterized by the presence of a duplicated condylar head. Although often asymptomatic and discovered incidentally on imaging, BMC can be associated with TMJ dysfunction, facial asymmetry, and a history of trauma or developmental disturbances. The clinical significance of BMC remains poorly understood, with controversies surrounding its etiology, classification, and management. This article presents a comprehensive literature review on the current understanding of BMC, supported by the presentation of a unique clinical case involving a symptomatic patient diagnosed through advanced imaging modalities. The diagnostic process, clinical presentation, and treatment approach are detailed to highlight the role of thorough evaluation and multidisciplinary management. Our findings suggest that while conservative management remains the mainstay in asymptomatic cases, individualized approaches are essential when functional disturbances are present. Further studies are warranted to clarify long-term outcomes and to standardize diagnostic and therapeutic protocols for BMC within maxillofacial practice.
{"title":"The interplay of soft tissue and osseous structures in bifid mandibular condyle: Implications for diagnosis and treatment. Case series and literature review","authors":"Gustavo Andres Grimaldi Finol , Alaa Abdulsattar Kadhim Al-Taie , Renan Elsadig Ibrahem Aadam , Ismail Farag , Abdul-Aziz ALaqeeli","doi":"10.1016/j.omsc.2025.100415","DOIUrl":"10.1016/j.omsc.2025.100415","url":null,"abstract":"<div><div>Bifid mandibular condyle (BMC) is a rare developmental or acquired anomaly of the temporomandibular joint (TMJ), characterized by the presence of a duplicated condylar head. Although often asymptomatic and discovered incidentally on imaging, BMC can be associated with TMJ dysfunction, facial asymmetry, and a history of trauma or developmental disturbances. The clinical significance of BMC remains poorly understood, with controversies surrounding its etiology, classification, and management. This article presents a comprehensive literature review on the current understanding of BMC, supported by the presentation of a unique clinical case involving a symptomatic patient diagnosed through advanced imaging modalities. The diagnostic process, clinical presentation, and treatment approach are detailed to highlight the role of thorough evaluation and multidisciplinary management. Our findings suggest that while conservative management remains the mainstay in asymptomatic cases, individualized approaches are essential when functional disturbances are present. Further studies are warranted to clarify long-term outcomes and to standardize diagnostic and therapeutic protocols for BMC within maxillofacial practice.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827594","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 : 2025-09-01Epub Date: 2025-08-22DOI: 10.1016/j.omsc.2025.100417
Alamira haya Salloum , Nayar Khadro , Iyad Ali , Mounzer Assad , Zuheir Alshehabi
Introduction
Chronic kidney disease (CKD) is an irreversible progressive glomerular disease, and it can cause many complications like osteodystrophy, hyperparathyroidism (HPT), or bone lesions such as Brown Tumors (BT)
BTs are rare slow-growing lesions in skeletal and facial bones and are benign.
This paper describes a patient with tertiary hyperparathyroidism (THPT) and CKD-MBD who developed a large maxillary BT.
Case presentation
A 28-year-old male presented with swelling in the maxillary bone caused by secondary hyperparathyroidism (SHPT) after 14 years of chronic kidney disease (CKD). Radiological examinations confirmed the presence of a bone lesion localized to the maxillary bone, indicating a tumor, followed by histological tests confirmed the tumor was a brown tumor and the role of CKD and SHPT hypothesis involvement. The tumor was treated surgically after controlling the other underlying conditions.
Discussion
The impaired kidney function in Chronic kidney disease (CKD) leads to vitamin D deficiency and abnormal calcium and phosphorus levels, which stimulate the parathyroid glands to overproduce parathyroid hormone (PTH), and alteration in bone resorption and formation leading to bone lesions like BTs.
The diagnosis of brown Tumors is quite challenging and usually requires a combination of clinical and laboratory examination with imaging.
The cornerstone in treating BTs is managing the underlying HPT, which may involve medication, surgery, or both.
Conclusion
Brown Tumors are a late complication of hyperparathyroidism and chronic kidney disease. A thorough medical history is essential for early diagnosis and appropriate treatment of BTs.
{"title":"The trinity of chronic kidney failure, hyperparathyroidism, and brown tumors: a case report","authors":"Alamira haya Salloum , Nayar Khadro , Iyad Ali , Mounzer Assad , Zuheir Alshehabi","doi":"10.1016/j.omsc.2025.100417","DOIUrl":"10.1016/j.omsc.2025.100417","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is an irreversible progressive glomerular disease, and it can cause many complications like osteodystrophy, hyperparathyroidism (HPT), or bone lesions such as Brown Tumors (BT)</div><div>BTs are rare slow-growing lesions in skeletal and facial bones and are benign.</div><div>This paper describes a patient with tertiary hyperparathyroidism (THPT) and CKD-MBD who developed a large maxillary BT.</div></div><div><h3>Case presentation</h3><div>A 28-year-old male presented with swelling in the maxillary bone caused by secondary hyperparathyroidism (SHPT) after 14 years of chronic kidney disease (CKD). Radiological examinations confirmed the presence of a bone lesion localized to the maxillary bone, indicating a tumor, followed by histological tests confirmed the tumor was a brown tumor and the role of CKD and SHPT hypothesis involvement. The tumor was treated surgically after controlling the other underlying conditions.</div></div><div><h3>Discussion</h3><div>The impaired kidney function in Chronic kidney disease (CKD) leads to vitamin D deficiency and abnormal calcium and phosphorus levels, which stimulate the parathyroid glands to overproduce parathyroid hormone (PTH), and alteration in bone resorption and formation leading to bone lesions like BTs.</div><div>The diagnosis of brown Tumors is quite challenging and usually requires a combination of clinical and laboratory examination with imaging.</div><div>The cornerstone in treating BTs is managing the underlying HPT, which may involve medication, surgery, or both.</div></div><div><h3>Conclusion</h3><div>Brown Tumors are a late complication of hyperparathyroidism and chronic kidney disease. A thorough medical history is essential for early diagnosis and appropriate treatment of BTs.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891846","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 : 2025-09-01Epub Date: 2025-08-05DOI: 10.1016/j.omsc.2025.100414
Mohammad Kouja, Abdul Karim Khalil
To evaluate the effectiveness of anterior segmental maxillary osteotomy in improving The amount of gingival exposure (above incisors and above canines) and the measurement of the nasolabial angle and increasing patient satisfaction in cases of excessive vertical growth of the upper jaw associated with a gummy smile.
Materials and methods
10 female patients, aged 20–34 years, were diagnosed with anterior vertical maxillary excess combined with a gummy smile. They underwent anterior segmental maxillary osteotomy using digital three-dimensional planning. Gingival exposure above the incisors and canines and the nasolabial angle were measured. Patient satisfaction was assessed using a numerical scale from 1 to 5 six months post-surgery.
Results
The findings demonstrated a statistically significant reduction in gingival exposure (from 7.00 mm to 1.20 mm above incisors, with an 97.14 % improvement) and (from 6.30 mm to 1.40 mm, with a 93.65 % improvement).And nasolabial angle(from 84.24° to 98.77° with 92.20 %).The average patient satisfaction score was 4.70 out of 5, with a low standard deviation (0.48), indicating a high level of satisfaction consistency among the patients.
Conclusion
Anterior segmental maxillary osteotomy is an effective and safe technique for improving gingival exposure over the maxillary incisors and canines, optimizing the nasolabial angle, and enhancing patient satisfaction in cases of excessive vertical maxillary growth associated with a gummy smile, particularly when performed with digital planning.
{"title":"Evaluation of the effectiveness of anterior segmental maxillary osteotomy in management of anterior vertical maxillary excess associated with gummy smile: A clinical study","authors":"Mohammad Kouja, Abdul Karim Khalil","doi":"10.1016/j.omsc.2025.100414","DOIUrl":"10.1016/j.omsc.2025.100414","url":null,"abstract":"<div><div>To evaluate the effectiveness of anterior segmental maxillary osteotomy in improving The amount of gingival exposure (above incisors and above canines) and the measurement of the nasolabial angle and increasing patient satisfaction in cases of excessive vertical growth of the upper jaw associated with a gummy smile.</div></div><div><h3>Materials and methods</h3><div>10 female patients, aged 20–34 years, were diagnosed with anterior vertical maxillary excess combined with a gummy smile. They underwent anterior segmental maxillary osteotomy using digital three-dimensional planning. Gingival exposure above the incisors and canines and the nasolabial angle were measured. Patient satisfaction was assessed using a numerical scale from 1 to 5 six months post-surgery.</div></div><div><h3>Results</h3><div>The findings demonstrated a statistically significant reduction in gingival exposure (from 7.00 mm to 1.20 mm above incisors, with an 97.14 % improvement) and (from 6.30 mm to 1.40 mm, with a 93.65 % improvement).And nasolabial angle(from 84.24° to 98.77° with 92.20 %).The average patient satisfaction score was 4.70 out of 5, with a low standard deviation (0.48), indicating a high level of satisfaction consistency among the patients.</div></div><div><h3>Conclusion</h3><div>Anterior segmental maxillary osteotomy is an effective and safe technique for improving gingival exposure over the maxillary incisors and canines, optimizing the nasolabial angle, and enhancing patient satisfaction in cases of excessive vertical maxillary growth associated with a gummy smile, particularly when performed with digital planning.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770944","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}
Papillary thyroid carcinoma presenting as a parapharyngeal mass is uncommon clinical presentation1,2. Papillary thyroid cancer is the most common primary thyroid cancer (80–90 % of cases)17. 20–50 % of cases have lymph node metastasis4. Superior thyroid lesions usually metastasize through superior pretracheal and cervical nodes while inferior thyroid and isthmus drainage travel via the paratracheal and deep cervical nodes17. Parapharyngeal space (PPS) tumors are rare and represent about 0.5 % of all head and neck tumors1,2. We report a case of 59 years-old man who presented initially with left parapharyngeal mass for about four months and a chief complaint of dysphagia. Exam revealed a submucosal 4 cm mass in the oropharyngeal wall, no tumor was palpable in the neck and his physical examination was otherwise unremarkable. Preoperative work up was completed, and Fine Needle Aspiration (FNA) was inconclusive. The mass was excised via transcervical-mandibular swing approach and a diagnosis of papillary thyroid carcinoma was rendered. Subsequently, the patient underwent a total thyroidectomy and neck dissection. This case report highlights the unusual metastasis to parapharyngeal space from occult papillary thyroid carcinoma, reviews the lymphatic drainage system of the head and neck responsible for this route of metastasis, recommendations for preoperative imaging, surgical treatment, and adjuvant treatment of this uncommon presentation.
{"title":"Occult papillary thyroid carcinoma presenting as parapharyngeal space mass: A case report and literature review","authors":"Fawaz Alotaibi , Harish Tummala , Mitchell Naito , Yousef Alshamrani","doi":"10.1016/j.omsc.2025.100402","DOIUrl":"10.1016/j.omsc.2025.100402","url":null,"abstract":"<div><div>Papillary thyroid carcinoma presenting as a parapharyngeal mass is uncommon clinical presentation<sup>1,2</sup>. Papillary thyroid cancer is the most common primary thyroid cancer (80–90 % of cases)<sup>17</sup>. 20–50 % of cases have lymph node metastasis<sup>4</sup>. Superior thyroid lesions usually metastasize through superior pretracheal and cervical nodes while inferior thyroid and isthmus drainage travel via the paratracheal and deep cervical nodes<sup>17</sup>. Parapharyngeal space (PPS) tumors are rare and represent about 0.5 % of all head and neck tumors<sup>1,2</sup>. We report a case of 59 years-old man who presented initially with left parapharyngeal mass for about four months and a chief complaint of dysphagia. Exam revealed a submucosal 4 cm mass in the oropharyngeal wall, no tumor was palpable in the neck and his physical examination was otherwise unremarkable. Preoperative work up was completed, and Fine Needle Aspiration (FNA) was inconclusive. The mass was excised via transcervical-mandibular swing approach and a diagnosis of papillary thyroid carcinoma was rendered. Subsequently, the patient underwent a total thyroidectomy and neck dissection. This case report highlights the unusual metastasis to parapharyngeal space from occult papillary thyroid carcinoma, reviews the lymphatic drainage system of the head and neck responsible for this route of metastasis, recommendations for preoperative imaging, surgical treatment, and adjuvant treatment of this uncommon presentation.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205666","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 : 2025-09-01Epub Date: 2025-05-26DOI: 10.1016/j.omsc.2025.100405
Asaad Shehada, Mazen Zenati
The temporomandibular joint has a variation in its atmospheric pressure during the mouth movement, although the intra-articular injection is widely used as one of the management strategies for reducing the pain and enhancing the mouth movement range, there are atmospheric fluctuations in the joint space due to make a passage between this closed spaces and the external medium when the needle inserted into the joint capsule. This report presents iatrogenic emphysema in two cases, while this emphysema is absent in a different case.
{"title":"Iatrogenic intra-temporomandibular joint emphysema during injection: A case report","authors":"Asaad Shehada, Mazen Zenati","doi":"10.1016/j.omsc.2025.100405","DOIUrl":"10.1016/j.omsc.2025.100405","url":null,"abstract":"<div><div>The temporomandibular joint has a variation in its atmospheric pressure during the mouth movement, although the intra-articular injection is widely used as one of the management strategies for reducing the pain and enhancing the mouth movement range, there are atmospheric fluctuations in the joint space due to make a passage between this closed spaces and the external medium when the needle inserted into the joint capsule. This report presents iatrogenic emphysema in two cases, while this emphysema is absent in a different case.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166766","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 : 2025-09-01Epub Date: 2025-07-05DOI: 10.1016/j.omsc.2025.100411
Safwan Salih, Sadeq Qanah, Fadi Nahhab
The head and neck region is a complex anatomical area where overlapping structures and nonspecific symptoms often make accurate diagnosis challenging. Facial pain, in particular, is a common yet ambiguous symptom frequently attributed to prevalent conditions like migraine, which can delay recognition of less common but clinically significant diseases. One such condition is Primary Sclerosing Fibroinflammatory Pseudotumor—a rare, benign lesion that can mimic malignancy both clinically and radiologically.We present the case of an 18-year-old female with chronic facial pain and globe displacement, misdiagnosed as migraine for four years. Imaging revealed a mass in the maxillary sinus with bone erosion and orbital involvement. A core needle biopsy was inconclusive, and definitive diagnosis was achieved only after surgical excision. Histopathological and immunohistochemical analysis confirmed Primary Sclerosing Fibroinflammatory Pseudotumor. The patient experienced substantial clinical improvement following combined surgical and corticosteroid therapy. This case highlights the importance of including rare pathologies in the differential diagnosis of maxillofacial masses and demonstrates the value of thorough investigation when symptoms persist despite standard treatment.
{"title":"Primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus misdiagnosed as migraine: A case report","authors":"Safwan Salih, Sadeq Qanah, Fadi Nahhab","doi":"10.1016/j.omsc.2025.100411","DOIUrl":"10.1016/j.omsc.2025.100411","url":null,"abstract":"<div><div>The head and neck region is a complex anatomical area where overlapping structures and nonspecific symptoms often make accurate diagnosis challenging. Facial pain, in particular, is a common yet ambiguous symptom frequently attributed to prevalent conditions like migraine, which can delay recognition of less common but clinically significant diseases. One such condition is Primary Sclerosing Fibroinflammatory Pseudotumor—a rare, benign lesion that can mimic malignancy both clinically and radiologically.We present the case of an 18-year-old female with chronic facial pain and globe displacement, misdiagnosed as migraine for four years. Imaging revealed a mass in the maxillary sinus with bone erosion and orbital involvement. A core needle biopsy was inconclusive, and definitive diagnosis was achieved only after surgical excision. Histopathological and immunohistochemical analysis confirmed Primary Sclerosing Fibroinflammatory Pseudotumor. The patient experienced substantial clinical improvement following combined surgical and corticosteroid therapy. This case highlights the importance of including rare pathologies in the differential diagnosis of maxillofacial masses and demonstrates the value of thorough investigation when symptoms persist despite standard treatment<strong>.</strong></div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581178","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 : 2025-09-01Epub Date: 2025-07-10DOI: 10.1016/j.omsc.2025.100409
Sagar Rane, Nitin Bhola, Chetan Gupta
Ossifying fibroma (OF) is a benign fibro-osseous tumor characterized by slow growth and a low recurrence risk, primarily affecting the mandible in young females. Although OF is typically non-invasive, rare cases demonstrate locally aggressive behavior, requiring surgical resection. Post-surgical transformation of into osteosarcoma, a rare malignancy with a prevalence of 0.7 per million in the jaw, is exceptionally uncommon. This report presents a rare case of a 28-year-old male initially diagnosed with ossifying fibroma, managed surgically through excision and reconstruction with an iliac crest graft. Despite achieving negative margins, the lesion underwent malignant transformation into fibroblastic osteosarcoma within a month, presenting diagnostic and therapeutic challenges.
The malignant transformation was confirmed through histopathological and immunohistochemical evaluations, revealing a high Ki-67 labeling index (60 %), indicative of aggressive tumor behavior. Following multidisciplinary tumor board discussions, the patient underwent extensive surgical management, including composite resection, segmental mandibulectomy, neck dissection, and microvascular reconstruction with a free fibula osteocutaneous flap. Despite its rarity, this case highlights the need for vigilant follow-up and comprehensive diagnostic workups for recurrent or progressive lesions post-OF resection.
This report contributes to the limited literature on malignant transformation in fibro-osseous lesions, emphasizing the importance of differentiating benign conditions from low-grade malignancies and discussing the role of surgical intervention in such transformations. Further research is required to elucidate the mechanisms of transformation, optimize management strategies, and improve outcomes for patients with similar rare pathologies.
{"title":"Tumor Transformation: Case of conversion of Ossifying Fibroma to Osteosarcoma post-excision in a young male","authors":"Sagar Rane, Nitin Bhola, Chetan Gupta","doi":"10.1016/j.omsc.2025.100409","DOIUrl":"10.1016/j.omsc.2025.100409","url":null,"abstract":"<div><div>Ossifying fibroma (OF) is a benign fibro-osseous tumor characterized by slow growth and a low recurrence risk, primarily affecting the mandible in young females. Although OF is typically non-invasive, rare cases demonstrate locally aggressive behavior, requiring surgical resection. Post-surgical transformation of into osteosarcoma, a rare malignancy with a prevalence of 0.7 per million in the jaw, is exceptionally uncommon. This report presents a rare case of a 28-year-old male initially diagnosed with ossifying fibroma, managed surgically through excision and reconstruction with an iliac crest graft. Despite achieving negative margins, the lesion underwent malignant transformation into fibroblastic osteosarcoma within a month, presenting diagnostic and therapeutic challenges.</div><div>The malignant transformation was confirmed through histopathological and immunohistochemical evaluations, revealing a high Ki-67 labeling index (60 %), indicative of aggressive tumor behavior. Following multidisciplinary tumor board discussions, the patient underwent extensive surgical management, including composite resection, segmental mandibulectomy, neck dissection, and microvascular reconstruction with a free fibula osteocutaneous flap. Despite its rarity, this case highlights the need for vigilant follow-up and comprehensive diagnostic workups for recurrent or progressive lesions post-OF resection.</div><div>This report contributes to the limited literature on malignant transformation in fibro-osseous lesions, emphasizing the importance of differentiating benign conditions from low-grade malignancies and discussing the role of surgical intervention in such transformations. Further research is required to elucidate the mechanisms of transformation, optimize management strategies, and improve outcomes for patients with similar rare pathologies.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632555","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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