RESUMO
The association between fibrous dysplasia (FD) and fractures is very rare. This paper reports the case of a zygomaticomaxillary complex fracture in a bone affected by FD, a 29-year-old man who was involved in a bicycle accident and who subsequently presented with a zygomaticomaxillary complex fracture. Computed tomography revealed multiple fractures of the left zygomaticomaxillary complex with dysplastic bone alterations. Fracture lines occurred near transitional areas between the lesion and healthy bone. The patient was treated through an intraoral approach by an open reduction and internal fixation procedure, using a titanium miniplate and screws. An incisional biopsy was performed through the maxillary sinus to confirm the diagnosis of FD. After 12 months of follow-up, there were no postoperative complications. This paper reports a rare association thought to be caused by irregular trabecular bone deposition, which increases bone thickness/resiliency and thus increases its clinical fracture resistance.
Assuntos
Displasia Fibrosa Monostótica/diagnóstico por imagem , Fraturas Maxilares/diagnóstico por imagem , Zigoma/diagnóstico por imagem , Fraturas Zigomáticas/diagnóstico por imagem , Acidentes de Trânsito , Adulto , Ciclismo/lesões , Placas Ósseas , Parafusos Ósseos , Tomografia Computadorizada de Feixe Cônico/métodos , Seguimentos , Fixação Interna de Fraturas/instrumentação , Humanos , Imageamento Tridimensional/métodos , Achados Incidentais , MasculinoRESUMO
Pathologic fractures may occur when a bone has been weakened by an underlying pathologic process. The treatment depends on the etiology. We report on a patient with pathologic fracture in the jaw caused by unicystic ameloblastoma. The lesion was subjected to marsupialization, and the size of the radiolucent lesion decreased. The fracture was consolidated by bone regeneration. For the remaining tumor, a secondary surgery was performed with enucleation followed by spray cryosurgery using a combination of propane, butane, and isobutane gases. The patient showed no signs of recurrence during the 3-year period after the second surgical procedure.
Assuntos
Ameloblastoma/cirurgia , Neoplasias Mandibulares/cirurgia , Ameloblastoma/diagnóstico por imagem , Ameloblastoma/patologia , Biópsia , Regeneração Óssea , Criocirurgia , Feminino , Humanos , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/patologia , Neoplasia Residual/diagnóstico por imagem , Neoplasia Residual/cirurgia , Radiografia Panorâmica , Reoperação , Adulto JovemRESUMO
Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Recently, bisphosphonates have been used to treat central giant cell lesions. A case of a 36-year-old male with a central giant cell lesion crossing the mandibular midline was treated with intralesional corticosteroids combined with alendronate sodium for the control of systemic bone resorption. The steroid injections and the use of bisphosphonates were stopped after seven months when further needle penetration into the lesion was not possible due to new bone formation. After two years, the bony architecture was near normal, and only minimal radiolucency was present around the root apices of the involved teeth. The patient was followed up for four years, and panoramic radiography showed areas of new bone formation. Thus far, neither recurrence nor side effects of the medication have been detected.
Assuntos
Corticosteroides/uso terapêutico , Difosfonatos/uso terapêutico , Granuloma de Células Gigantes/tratamento farmacológico , Doenças Mandibulares/tratamento farmacológico , Adulto , Granuloma de Células Gigantes/diagnóstico por imagem , Humanos , Injeções Intralesionais , Masculino , Doenças Mandibulares/diagnóstico por imagem , Radiografia PanorâmicaRESUMO
Odontodisplasia regional é uma afecção rara, não-hereditária, a qual afeta o desenvolvimento do esmalte e dentina na dentição decídua e/ou permanente. A etiologia ainda é desconhecida. Em geral, esta condição é diagnosticada durante exames radiográficos de rotina e muitos casos são diagnosticados erroneamente como dentes malformados ou odontomas. Esta condição afeta duas vezes mais o sexo feminino do que o masculino e envolve com mais frequência à maxila do que a mandíbula. Esta afecção é também mencionada como "dentes fantasmas", uma vez que os dentes afetados, radiograficamente, não apresentam distinção dos limites entre o esmalte e a dentina; e a câmara pulpar se apresenta alargada. Clinicamente os dentes são vistos com uma coloração castanha ou amarelada. O presente trabalho apresenta um caso clínico de odontodisplasia regional, não usual, que cruza a linha média da maxila, em uma criança do sexo feminino de quatro anos de idade. Todos os dentes decíduos e permanentes superiores do lado esquerdo eram displásicos, assim como também os incisivos centrais, decíduo e permanente do lado direito.
Regional odontodysplasia is a rare, nonhereditary condition that affects the development of the enamel and dentin of the deciduous and/or permanent teeth. The etiology is still unknown. In general, this condition is diagnosed during routine radiographic assessments and many cases are mistaken for malformed teeth or odontomas. This condition affects twice as many females as males and is more common in the maxilla than the jaw. This condition is also called "ghost teeth" because the enamel-dentine border of the affected teeth cannot be distinguished in the radiograph and the pulp chambers are wide. Clinically, the teeth are brownish or yellowish. The present study reports an unusual case of maxillary regional odontodysplasia crossing the midline in a 4-year-old female. All deciduous and permanent teeth in the left side of the maxilla and the central incisors in the right side of the maxilla were dysplastic.