RESUMEN
INTRODUCTION: Fibrous dysplasia (FD) and aneurysmal bone cyst (ABC) are uncommon non-neoplastic intraosseous lesions, and the occurrence of concomitant FD and ABC is extremely rare. CASE REPORT: An 11-year-old boy presented with gradual progressive enlargement of his right zygomatic bone over 4 years prior to presentation. Computed tomography revealed a lesion with a central bony area showing a ground-glass appearance surrounded by a well-defined expansile lesion with internal septations. An incisional biopsy was performed and suggested a fibro-osseous lesion. Resection was performed, followed by immediate reconstruction using autogenous bone graft from the iliac crest. Histopathological examination revealed irregularly shaped trabeculae comprising immature woven bone in a fibroblastic cell-rich stroma. Blood-filled sinusoidal spaces lined by fibrous septa containing scattered multinucleated giant cells were observed peripherally. These findings were compatible with concomitant FD and ABC. The patient was disease-free at the time of his 10-month follow-up. CONCLUSIONS: Based on our literature search, this report is the first to describe concomitant monostotic FD and ABC in the zygomatic bone. Accurate diagnosis requires careful investigation and examination of clinical, radiographical, and histopathological features. The treatment of choice should provide an esthetic and functional improvement in the patient.
Asunto(s)
Quistes Óseos Aneurismáticos , Trasplante Óseo , Niño , Estética Dental , Humanos , Ilion , Masculino , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To evaluate clinically and radiographically, in humans, the healing of maxillary third molars postextraction sockets after application of different ridge preservation techniques 3 months after tooth extraction. MATERIALS AND METHODS: Twenty-six sockets (13 patients) were randomly assigned to 4 treatment modalities: deproteinized bovine bone mineral with 10% collagen (DBBM-C), poly(D,L-lactide-co-glycolide) with hydroxyapatite/ß-TCP scaffold (PLGA/HA), PLGA/HA/ß-TCP with 2.0% simvastatin scaffold (PLGA/HA/S), and spontaneous healing (control). Clinical complications were assessed, and cone-beam computed tomographies were taken in 5 patients 3 months after surgeries. For statistical purposes, the Fisher exact test was used (P < 0.05). RESULTS: After 3 months, 6 of 9 grafts from the PLGA/HA group were lost (P < 0.05). PLGA/HA/S' loss was only 2 of 8 (P > 0.05), but no loss was observed in the DBBM-C group. Pain was present in 3 of 8 sites that lost the graft (37.5%) (P > 0.05) and infection in 1 of 8 (12.5%) (P > 0.05), with these only occurring in the PLGA/HA group. CONCLUSIONS: Poly (D, L-lactide-co-glycolide) with hydroxyapatite/ß-TCP (PLGA/HA/ß-TCP) scaffolds, with and without simvastatin, failed to obtain the initial expected results and presented more complications. Scaffolds with simvastatin showed to be superior, with less clinical complications than scaffolds without simvastatin.
Asunto(s)
Aumento de la Cresta Alveolar/métodos , Materiales Biocompatibles/uso terapéutico , Sustitutos de Huesos/uso terapéutico , Fosfatos de Calcio/uso terapéutico , Colágeno/uso terapéutico , Durapatita/uso terapéutico , Ácido Láctico/uso terapéutico , Maxilar/cirugía , Minerales/uso terapéutico , Tercer Molar/cirugía , Ácido Poliglicólico/uso terapéutico , Simvastatina/uso terapéutico , Andamios del Tejido , Extracción Dental , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Proyectos Piloto , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Porosidad , Estudios Prospectivos , Adulto JovenRESUMEN
This report describes an atypical case of spontaneous mandibular regeneration of a large size bony defect after resection of an aseptic osteonecrotic area near the symphysis and parasymphyseal area. The patient underwent orthodontic therapy, vertical osteogenic distraction of the alveolar bone, and oral rehabilitation with an implant borne prosthesis. This case study also describes the 10-year follow-up of comprehensive multidisciplinary treatment and successful recovery of a patient's esthetic and functional aspects.