Urachal carcinoma with metastasis to the maxilla: the first reported case

A case is reported for the first time of a urachal carcinoma with metastasis to the maxilla. The patient presented with a hard swelling along the left upper jaw in the region of 24-27. At the time of onset there were skin changes and signs of metastasis to the brain. The patient died 13 months after the onset of symptoms.

Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients

This prospective study was designed to record relevant characteristics of mandibular condyle fractures and to evaluate the relationship between these. Data were recorded on sex, age, cause of trauma, level of fracture, dislocation of the mandibular head, dental state and associated fractures of all patients diagnosed in our hospital during the period 1984-1996 with mandibular condyle fractures. Data were analysed in our Computer Department. The sample comprised 348 patients with 444 fractures, and a male:female ratio of 2:1. Traffic accidents were the most common cause: 103 (41%) of the unilateral and 54 (56%) of the bilateral fractures, followed by alleged assault and falls. Low fractures were the most common -n = 314 of 444 (71%). The causes that involved considerable force (traffic accidents and falls) resulted in more dislocations of the mandibular head, more bilateral fractures, a tendency to fractures higher on the condyle and significantly more intracapsular fractures. Absence of molar occlusion also gave more high and fewer low fractures, but played no part in dislocation of the mandibular head from the glenoid fossa.

Fractures of the mandibular condyle. Part 2: results of treatment of 348 patients

This study was designed to record the results of conservative treatment of condylar fractures and to find out if there were any variables that were predictive of complications. Data were analysed in our computer department. During the period 1984-1996, all patients who presented with a fracture of the mandibular condyle and who attended for control examination one year after treatment were recorded at the end of treatment and one year later. The ability to open the mouth, deviation and occlusion were recorded. After one year 45 of the 348 patients (13%) had minor physical complaints such as reduced ability to open the mouth, deviation, or dysfunction. Ten of them (3%) had pain in the joint or muscles or both. Eight patients (2%) had malocclusion, which in seven could be related to dislocation of the condylar head out of the fossa. Five of the eight patients had had bilateral fractures. We conclude that conservative treatment of condylar fractures is non-traumatic, safe, and reliable and in only a few cases may cause disturbances of function and malocclusion. The risk associated with the latter is greatest with bilateral fractures and dislocation of the condylar head from the fossa.

Treatment of large odontogenic keratocysts by decompression and later cystectomy: a long-term follow-up and a histologic study of 23 cases

OBJECTIVE

The purpose of this study was to determine the course of healing, the frequency of recurrence, and the changes in the epithelium of keratocysts after decompression treatment.

STUDY DESIGN

The treatment of 23 keratocysts, which had been divided into two groups (12 and 11 patients, respectively), was carried out in two phases: (1) insertion of a polyethylene drain and removal of a biopsy specimen from the cyst wall, and (2) cystectomy and removal of the drain approximately 1 year later. Histologic examination of the biopsy material from the two phases was carried out, and the material classified according to Forssell.

RESULTS

Reduction in cyst volume together with bone healing occurred in all cases, although there was recurrence in two patients. Decompression resulted in substantial histologic changes in the epithelium in 19 cases (83%).

CONCLUSIONS

(1) Decompression results in new bone formation and thickening of the cyst wall. (2) This treatment conserves bone and anatomic structures. (3) The frequency of recurrence is low. (4) The keratocyst epithelium is modulated histologically to nonkeratocyst after decompression.

A randomized, double-blind, placebo-controlled, dose-response study of the analgesic effect of lornoxicam after surgical removal of mandibular third molars

The aim of the present study was to investigate the dose-effect relationship of single doses of 4 to 32 mg of lornoxicam (LNX), a new nonsteroidal antiinflammatory drug belonging to the oxicam group, compared with placebo and 10 mg ketorolac (KET) in the treatment of pain after oral surgery. Also, it was the aim of the study to evaluate the relationship between adverse events and different doses of LNX. After the surgical removal of a mandibular third molar, test medication was taken when the patients experienced at least moderate pain. After medication, pain relief, pain intensity, and any discomfort from the medication were noted in a questionnaire. Paracetamol was used as rescue medication. A total of 278 patients completed the study according to the protocol. The primary efficacy parameter was total pain relief after 6 hours, and all active treatments showed significantly better effect than placebo, with LNX 16 and 32 mg being significantly superior to LNX 4 mg. All other efficacy parameters showed the same dose-effect relationship. A total of 37 adverse events were reported evenly distributed in the 6 treatment groups; only 3 of these were considered severe, and all disappeared without treatment. In conclusion, the study showed a dose-effect relationship of LNX without a rise in adverse events. The effect of 10 mg KET seemed to be at the level of 8 to 16 mg LNX.

[Necrotizing sialometaplasia]

Necrotizing sialometaplasia is a benign, self-limiting disease that requires no treatment. It is often confused with malignancy, resulting in unnecessary, extensive surgery. Clinicians need to be aware of this lesion and include it in a differential diagnosis of ulcerated lesions, especially in the hard palate. Correct diagnosis depends upon histological diagnosis by a pathologist who is familiar with the characteristics of this disease. One case is presented and the total number in our department from 1985-1991 is summarized.

[Bilateral eminectomy in the surgical management of recurrent jaw luxation]

The different types of luxations in the temporomandibular joint and their management are discussed. The bilateral eminectomia a.m. Myrhaug is described, and the results from our Department are presented. Seven patients have been operated, and all are relieved of their disease and free from pain. The patients are happy with the operations and there have been no postoperative complications. All the patients would recommend this type of operation to others in a similar situation.

[A case of a solitary osteoma in the mandible]

A case of osteoma in the angular mandibular region is presented and discussed. A survey of the literature on osteomas shows some confusion about the classifications exostosis and torus, which in a number of cases should be regarded as hamartomaz.

[Fractures of the mandible--an analysis of the etiology and localization]

A retrospective analysis of fractures of the mandible in 993 patients treated in the Department of Oral Surgery, Odense University Hospital, during the period 1978-1987 is presented. The investigation is compared with a previous analysis from the period 1964-1973. There is a marked increase in the total number of fractures as well as an increase in the number of cases of violence involving fractures of the mandible. Jaw fractures caused by sport accidents are rare, but it is surprising that horse riding is the sport that is causing most mandibular fractures. The present investigation demonstrates that fractures of the condyles are the prevailing type of fractures, followed by fractures of the mandible body. Presence or lack of teeth seems to have no or little importance with reference to localization of the fractures.