Central Giant Cell Granuloma (CGCG) is a benign, proliferative, intraosseous and nonodontogenic lesion of unknown etiology accounting for approximately 10% of all benign lesions of the jawbones. Lesion usually occurs in patients younger than 30 years, is more common in females than males, and is more common in mandible than maxilla. The clinical feature of CGCG ranges from a slow growing asymptomatic swelling to a rapidly enlarging aggressive lesion. CGCG of the jaws are histologically benign lesions characterized by the presence of giant cells in the richly vascularized stroma of the spindle cells. Differential diagnosis should be performed with other lesions that have multinucleated giant cells (MGCs). Definitive diagnosis relies on correct interpretation of clinical, radiographical and histopathological data. The treatment of CGCG ranges from curettage to resection. Alternative treatments are worthy of consideration, although surgical excision remains the treatment of choice. The aim of this presented case highlights a diagnostic challenge of an aggressive CGCG arising from the maxilla and to discuss a precise differential diagnosis, as well as the surgical approach and follow up which is decisive for successful conventional surgical treatment with no lesion recurrence.
Regional odontodysplasia (ROD) is a rare dental anomaly that can affect deciduous and permanent dentition. This unique dental abnormality involves enamel, dentin, pulp, and dental follicle. ROD has a prevalence of less than 1:1.000.000 and the age at the time of diagnosis ranges from 1 to 23 years. Females are slightly more affected than males at a ratio of 1.4:1. The maxilla is affected twice as often as the mandible. The aetiology of ROD is still unknown and conditions such as viral infections, local trauma, vascular defects, irradiation, metabolic disturbance, rhesus incompatibility and medications during pregnancy have been suggested as possible causes. The diagnosis is usually made by clinical and radiographic findings. Generally, the affected teeth fail to erupt, but when erupted, they are small, hypoplastic, or hypocalcified with deep pits and clefts which could be connecting the pulp. Radiographically, the affected teeth show a typical "ghost-like" appearance. The affected teeth have large pulp chambers and short roots with open apices. The treatment of ROD is controversial. It is widely accepted that implant-supported single-unit crowns represent a reliable treatment option for the replacement of missing teeth with favourable outcomes. The objective of this review and reported case highlights epidemiology, etiopathogenesis, diagnosis, and implant treatment modality.
The traumatic bone (TBC) cyst is an uncommon benign empty or fluid containing cavity within bone that is not lined by epithelium. The etiopathogenesis of TBC is still unknown. TBC is frequently encountered in young patients during the second and third decades of life. Sex predilection is equal but some studies in literature suggest clear female predominance. Body of the mandible between the canine and the third molar is the most common site (75%) in head and neck region followed by mandibular symphysis. The cysts are usually asymptomatic. Associated teeth are usually vital with no resorption or displacement. It expands the cortices and, seldom, intraoral or extra oral swelling may be seen. Most of the TBCs are diagnosed incidentally in orthopantomogram (OPG). On radiographic examination, a unilocular irregular but well defined lytic lesion is seen characteristically extending between the roots of the teeth. TBC is representing approximately 1% of all jaw cysts. A final diagnosis of a TBC is almost invariably made at the time of surgery, where in identification of an empty air-filled cavity serves as a valuable diagnostic tool. Surgical exploration was proved not only essential in making the right diagnosis but also curative from a treatment plan perspective. Recurrence of TBC is assumed to be extremely rare. However, a distinct proportion of recurrences may occur.
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