a b s t r a c tWe encountered a patient with a huge osteoma extending over half of the mandible, which was incidentally discovered on a head-and-neck computed tomography (CT) by an otolaryngological examination for vertigo.A tumorous lesion of the right mandible was noted, and the patient was referred to our department. The tumor extended from the median mandible over the right anterior margin of the ramus of the mandible.To improve the abnormal intraoral morphology, tumor resection and orthopedic surgery were performed. The histopathological diagnosis was a cancellous osteoma.Dentures were attached after surgery, and the postoperative course has been favorable with no tumor re-enlargement.

BTWs offer a significant advantage over PAs in the diagnoses of early stages of interproximal carious lesions.

No abstract

Radiation therapy (RT) plays a significant role in the management of head and neck malignancies. This study aimed to review the clinical symptoms and various imaging findings of osteoradionecrosis (ORN) and provide a clinical perspective on the development of ORN. The retrospective cohort was composed of 57 sites in 54 patients who had a history of RT and suspected ORN and 48 sites in 45 patients who were confirmed to have ORN. Image analyses included computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, bone scintigraphy, and single-photon emission CT (SPECT). The irradiated tissue was damaged by RT, and the extent of damage was correlated with clinical symptoms. The bone marrow showed sclerotic changes and the devitalized bone showed bone resorption after invasive stimulation. Chronic trismus and pathological fracture are considered severe conditions, typically occurring in the last stage of ORN. Furthermore, neurological symptoms were an important sign of tumor recurrence, since diagnostic imaging was difficult. The possible treatment options vary depending on the stage of ORN. We speculate that bone sclerosis reactions and bone resorption are sequential reactions that seem to be protective measures of the bone to radiation injury.

Combined intra-arterial infusion and systemic chemoradiotherapy may be an effective treatment for patients with stage IV mandibular gingival cancer.