Peripheral ameloblastoma: case report and review of literature

Peripheral ameloblastoma: case report and review of literature

e268 E-Poster Presentation Findings and conclusions: The incidence of NSI was significantly decreased during the course of postoperative periods and...

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E-Poster Presentation

Findings and conclusions: The incidence of NSI was significantly decreased during the course of postoperative periods and 12% of cases showed persistent NSI 1 year after the surgery. Interestingly, mandibular advancement was not involved in those cases and the amount of movement did not influence on it. Further statistical analyses revealed that close correlation between the exposure of IAN during the surgery and the incidence of NSI, and the case with mandibular canal located proximally to the lateral cortex at the level of ascending ramus has high-risk for the incidence of persistent NSI. A case of metastatic pleural mesothelioma in the maxillary gingiva K. Nakamatsu 1,∗ , K. Koga 1 , S. Chigita 1 , Ying Wang 1 , C. Minemura 1,2 1 2

Iizuka Hospital, Iizuka, Japan Japan Self Defense Force Sasebo Hospital, Sasebo, Japan

Malignant pleural mesothelioma (MPM) arises from the surfaces of the parietal or pulmonary pleura. Most of MPM are caused by asbestos exposure and the latent period is as long as 20–40 years. Patients with MPM in Japan are expected to increase because Japan had used a lot of asbestos until recently. MPM invades directly to adjacent organs and highly metastasizes to the thoracic lymph nodes, but metastasis rarely occurs to distant organs. Metastasis to the oral cavity is particularly rare. We report the case of a 66-year-old male with metastatic mesothelioma to the maxillary gingiva. A case of dislocation of the mandibular condyle into the cranial fossa K. Nakamura 1,∗ , M. Kanamoto 1 , N. Akimoto 1 , S. Oka 2 , Y. Horinouchi 2 1

Osumi Kanoya Hospital, Kagoshima, Japan Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan


Traumatic dislocation of the mandibular condyle into the middle cranial fossa is rare but highly significant result of trauma to the mandible. A case is reported of a patient, female, 27 years old who fell from her bicycle, striking chin on the pavement and dislocated the right mandibular condyle into the middle cranial fossa. She was admitted to the emergency department, had been mainly complaining of occlusal dysfunction and sustaining lacerations to her chin. She underwent CT scan, which revealed a broken middle cranial fossa and turbidity of mastoid cells. The initial diagnosis was made by neurological surgeons, and the patient was treated at our department. A resin pivot was placed between the right upper and lower molars and continuous elastic intermaxillary traction was applied. The condylar head was reinstated in the mandibular fossa after reduction, but no neurological complications occurred. After intermaxillary fixation for two weeks, we started functional training. The patient had been followed for a month, her maximal mouth opening was 35 mm without re-dislocation. Radiographic images demonstrated satisfactory occlusion and jaw movement, except for slight deviation on maximum opening. Patients with such cases require long-term follow-up because

of the potential for craniofacial asymmetries and neurological complications. Modifications of horseshoe Le Fort I osteotomy for the safety A. Nishiyama ∗ , N. Yoshioka, S. Ibaragi, S. Domae, K. Kishimoto, T. Shimo, A. Sasaki Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan Background: Recently horseshoe Le Fort I osteotomy (HLFO) makes us to get large superior repositioning for correcting open bite and gummy smile. On the other hand, we must consider some complications of root damage or palatal mucosa injury. Therefore we take a modification of osteotomy line and some technical procedures in addition to check the 3-D and MPR imaging and rapid prototyping from CT data. We will present our modification and procedures of HLFO. Materials and methods: (1) Short segment HLFO for severe open bite patient. Correcting open bite needs large superior repositioning at the only posterior portion of the maxilla. In this case, we make a small palatal segment with short bilateral sagittal osteotomies through the maxillary sinus in the minimal risk of root damage. (2) Unilateral HLFO for occlusal cant patient. In case of unilateral large superior repositioning for correcting severe occlusal cant, we perform unilateral HLFO at larger impaction side and sagittal osteotomy at the nasal floor of the opposite side. (3) HLFO following bone removal of nasal floor of the anterior portion for gummy patient. The palatal bone of the anterior portion is thick, and transverse osteotomy on this site will be often blind operation. To remove the bone of nasal floor at the anterior dentoalveolar component in advance makes the osteotomy easier with a clear visual field. Findings and conclusions: We could prevent injury of root and mucosa by application of these modifications in HLFO. These modifications were effective technique for the safety and accuracy. Peripheral ameloblastoma: case report and review of literature S. Ogane 1,∗ , T. Onda 1 , S. Yamada 1 , R. Ohta 1 , H. Ohhata 1 , N. Takano 2 , T. Shibahara 1 1 Tokyo Dental College, Department of Oral and Maxillofacial Surgery, Chiba, Japan 2 Ichikawa General Hospital, Oral Cancer Center, Ichikawa, Japan

Background: According to the 2005 histological classification of odontogenic neoplasmas by the World Health Organaization (WHO), ameloblastoma is an epithealial odontogenic tumor that occurs most frequently in the jaws. However, Peripheral ameloblastoma is an uncommon variant of ameloblastoma occurring in tha extraosseous region, which accounts for only 2–10% of all types of ameloblastoma. The report describes case with peripheral ameloblastoma filed at this hospital, review of Literature.

E-Poster Presentation Case: The present report discusses a case of peripheral ameloblastoma in the mandibular gingiva. The patient was a 45-year-old man who presented with a 15 mm × 10 mm × 7 mm tumor on the gingiva of the right mandibular molar region. CT and MRI examinations showed no resorption of bone. We performed excisional biopsy with a rim of surrounding nomal tissue under general anesthesia. According to the clinical and pathological features, a diagnosis of peripheral ameloblastoma was made. There was no evidence of recurrence at 10 mouths of postoperative follow-up. A review of the literature is also performed, focusing on the epidemiological and pathological aspects of the lesions and their implications on the therapy. A clinical study of endodontic microsurgery for extensive radicular cysts M. Ogawa ∗ , A. Musha, T. Makiguchi, S. Yokoo Gunma University Graduate School of Medicine, Department of Stomatology and Maxillofacial Surgery, Gunma, Japan Background: In the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, relatively large radicular cysts extending over 3 or more teeth are treated with a combination of complete excision, endodontic microsurgery and Er:YAG laser irradiation, whereby favorable outcomes have been achieved. The purpose of this report is to describe our surgical procedure and discuss the therapeutic outcomes. We achieved markedly favorable outcomes: 100 and 90% in the treatment of maxillary and mandibular radicular cysts, respectively. Objectives: Patients between December 2008 and December 2014 with radicular cysts pathologically extending over 3 or more teeth, who were followed up for 1 year or longer, participated in this study. Methods: The outcomes were comprehensively evaluated based on clinical signs and radiographs. The clinical signs included fistulation in the root apex, pressure pain, the presence or absence of percussion pain of the teeth and tooth mobility. Radiographic evaluation was performed according to the method of Tsiklaskis et al. A decrease of ≥75% in the radiolucent area of a cyst was considered as satisfactory healing, 50–75% as curative tendency and <50% as delayed healing. Satisfactory healing and curative tendency were classified as successful. Findings and conclusions: The comprehensive evaluation demonstrated an overall success rate of 94.1% (maxilla: 91.7%, mandible: 100%). The results of our study suggest that this procedure is very useful for extensive radicular cysts.


Correction of proximal segment displacement in patients treated by the surgery-first orthognathic surgery: report of two cases B.G. Kim 1 , M.I. Kim 1 , J.W. Lee 1 , M.S. Kook 1 , H.J. Park 1 , H.S. Hwang 2 , H.K. Oh 1,∗ 1 Chonnam National University, Department of Oral and Maxillofacial Surgery, School of Dentistry, Gwangju, South Korea 2 Chonnam National University, Department of Orthodontics, School of Dentistry, Gwangju, South Korea

Background: Early postoperative displacement occurs as a result of inadequate mobilization of the repositioned jaws, bony interferences that are not corrected by repositioning, and the lack of passive seating of the condyles within the mandibular fossa during fixation. Postoperative displacement of mandibular proximal segment could be observed in orthognathic surgery using the surgery-first approach. Furthermore, occlusal instability may exacerbate the tendency of relapse when the surgery-first approach is used. If postoperative displacement is minimal, it can be managed by traction with dental elastics. However, more significant displacement might require re-operation in the majority of cases. Objectives: We report this case study to share the technique and the experience of management of postoperative displacement of proximal segment in patients of surgery-first orthognathic surgery. Methods: Surgery-first orthognathic surgery was decided and done after close consultation with Dept. of Orthodontics in two patients of facial asymmetry. Postoperatively, however, displacement of proximal segment was observed. It was managed by the early removal of internal fixation on the mandible at 4 weeks after the operation and traction with arch bar and elastics. Findings and conclusions: The mandibular position was improved and the occlusion stabilized after postoperative orthodontic treatment in patients. This approach can resolve moderate condylar and proximal segment displacement that occurs in patients undergoing the surgery-first approach without reoperation. Comparison of the skeletal stability after sagittal split ramus osteotomy with physiological positioning strategy in patients with skeletal symmetry or asymmetry S. Ohba 1,∗ , N. Nakao 2 , T. Kawasaki 1 , T. Minamizato 1 , N. Yoshida 2 , I. Asahina 1 1 Nagasaki University Graduate School of Biomedical Sciences, Department of Regenerative Oral Surgery, Unit of Translational Medicine, Nagasaki, Japan 2 Nagasaki University Graduate School of Biomedical Sciences, Department of Orthodontics and Dentofacial Orthopedics, Unit of Translational Medicine, Nagasaki, Japan

Background: Correction of jaw deformity with facial asymmetry is a great challenge because of high incidence of relapse which may be partially due to skeletal interference after osteotomy and inappropriate seating of TMJ after the rigid fixation of the bony segments. To decrease the bony interference, short lingual osteotomy (SLO) was adopted in this study because of its minimum bone interference. The bony segments were not fixed after osteotomy and postoperative management was followed by physiological positioning strategy (PPS). In PPS, the proximal