Management of mandibular fractures in children.

To guide surgeons treating mandibular fractures in children, this article first reviews the growth of the mandible, describes how injury can affect such growth, and explains how to harness the process of growth to good effect. This information is important in making therapeutic decisions about the management of such injuries. The article then reviews the various opinions regarding diagnosis, treatment, and outcomes.

Dealing with the effects of juvenile rheumatoid arthritis in growing children.

Juvenile rheumatoid arthritis is a chronic childhood disease that has a multiplicity of effects on the growth and development of the facial skeleton. An understanding of the disease in general and its therapy is necessary for successful surgical-orthodontic care.

Imaging findings of bisphosphonate-associated osteonecrosis of the jaws.

Background And Purpose: Bisphosphonates are drugs that decrease bone turnover by inhibiting osteoclast activity. An association between the use of bisphosphonates and osteonecrosis of the maxilla and mandible has recently been described. This study describes the imaging findings of bisphosphonate-associated osteonecrosis of the jaws.

A comparative study of 2 imaging techniques for the diagnosis of condylar fractures in children.

Purpose: We sought to compare the sensitivity and specificity of panoramic radiographs with those of coronal computed tomography (CT) scans in the diagnosis of mandibular condylar fractures in the pediatric population.

Methods: Medical, dental, and radiographic records of patients who presented between 1995 and 2000 were evaluated for injuries involving the mandibular condyle. The sample included 22 males and 15 females with ages ranging from 2 to 15 years (mean, 8 years).

Orofacial rhabdomyosarcoma in neonates and young children: a review of literature and management of four cases.

Rhabdomyosarcoma (RMS) is an aggressive malignant skeletal muscle neoplasm arising from embryonal mesenchyme. It accounts for over 50% of all pediatric soft tissue sarcomas. The head and neck region is the most common site for this tumor in children.

Conservative management of recurrent keratocysts in Basal-cell naevus syndrome.

Basal-cell naevus syndrome is characterized by multiple odontogenic keratocysts as well as skeletal, ophthalmologic and neurologic features. It is important that the dental practitioner be aware of this syndrome as it has important ramifications for the developing dentition. A case of Basal-cell naevus syndrome is presented along with a review of the literature regarding the management of this disorder.

Congenital bony syngnathia: a proposed classification.

Congenital bony syngnathia is an extremely rare condition characterized by bony fusion of the jaws. Five new cases are described and the existent literature is reviewed. A classification system is proposed and treatment recommendations based on this classification are presented.

Unusual presentations of injuries associated with the mandibular condyle in children.

Condylar fractures are sustained commonly by children and are readily diagnosed in the main. Three case histories serve to illustrate the intricate anatomy of the area and how damage to it can produce unusual signs and symptoms which can mislead the unwary. Supplemental images, in particular coronal CTs, can be instrumental in arriving at the correct diagnosis and treatment.

Pain following iliac crest bone grafting of alveolar clefts.

The purpose of this study was to investigate pain following iliac crest bone grafting of alveolar clefts. The study involved 34 consecutive patients requiring secondary alveolar bone grafting. The study population consisted of 21 males and 13 females with a mean age of 11 years (SD = 3.

Stability of Le Fort I osteotomy with maxillary advancement: a comparison of combined wire fixation and rigid fixation.

Purpose: This study compares two types of fixation: intraosseous wires, skeletal suspension wiring, and maxillomandibular fixation (combined wire fixation; CWF) with rigid internal fixation (RIF) in patients who underwent Le Fort I osteotomy to correct maxillary hypoplasia.

Materials And Methods: All patients were operated on by the same surgeon using a standard technique, which included bone grafting. The 12 patients in group A were treated with CWF for 4 weeks.

Septic arthritis of the temporomandibular joint: review of the literature and report of two cases in children.

Septic arthritis of the temporomandibular joint (TMJ) has a high morbidity, is infrequently reported, and has been described almost exclusively in adults. We present two cases of septic arthritis of the TMJ that occurred in children after minor blunt trauma. Literature related to septic arthritis of the TMJ was reviewed, and a composite list of cases was constructed.

Odontogenic myxoma: histochemical and ultrastructural study.

Three cases of odontogenic myxoma are presented, two of which were located in the mandible and one in the maxilla. All cases demonstrated similar morphology by light microscopy. Immunohistochemical studies demonstrated positive reaction with antibodies to vimentin and actin, and negative reaction to antibody to S-100 protein.

Intraoral infantile hemangiopericytoma: literature review and addition of a case.

A rapidly growing neoplasm in the buccal mucosa of a 4-month-old baby was excised. By light and electron microscopy the neoplasm had features that were similar to those described in infantile hemangiopericytoma, a rare neoplasm of vascular origin. By light microscopy the neoplasm was multilobular with highly proliferating round to spindle-shaped cells interspersed with numerous vascular spaces.

Orbital abscess of odontogenic origin. Case report and review of the literature.

A case is discussed of a patient with an orbital cellulitis and a post septal abscess secondary to infection from an upper molar tooth. Spread of infection was to the maxillary sinus and thence to the orbit via a defect in the orbital floor. The clinical presentation, differential diagnosis, value of CT scanning, treatment and possible complications are reviewed.

Jaw deformity caused by juvenile rheumatoid arthritis and its correction.

An underdeveloped mandible and resulting micrognathia and malocclusion may occur in some children with juvenile rheumatoid arthritis. Combined orthodontic and surgical procedures can now greatly improve esthetics and function in such children. We describe corrective treatment and followup of 7 patients.

Are you overlooking fractures of the mandibular condyle?

Fractures of mandibular condyle may be overlooked because attention is often focused on readily apparent soft tissue injury such as lacerations and abrasions. Clinical and radiographic signs are often subtle, but the injuries caused by rapid deceleration and listed in Table 2 will serve to alert the pediatrician to the possibility of such fractures. All children in these circumstances should be carefully examined for dental occlusion and the preauricular area palpated to help formulate a clinical diagnosis.

Severe hemorrhage from an arteriovenous malformation of the mandible: report of case.

A case of a potentially lethal arteriovenous malformation of the mandibular bone in a 6.5-year-old girl is reported. Diagnosis is often difficult and the AVM may be discovered only when a tooth is extracted.

Chronic factitious illness: recognition and management of deception.

Factitious disease is often manifested in the head and neck region. It is only when the oral and maxillofacial surgeon is aware of the existence of this syndrome and has been unable to correlate a patient's history and signs and symptoms with known diseases that factitious illness may be suspected as the diagnosis. Three case histories that help to demonstrate the variety of ruses used by patients to feign illness are presented.

Patients with long Q-T syndrome: a caveat for the oral surgeon.

Three children with long Q-T syndrome were admitted to the hospital for elective minor oral surgery. Patients afflicted with this syndrome often have a family history of recurrent syncope, prolongation of the Q-T interval on the electrocardiogram, sometimes deaf mutism, and occasionally sudden death. Their cardiac dysrhythmias are controlled by a variety of medications, all of which must be understood before the oral surgical procedure is undertaken, so that potentially lethal events can be recognized and dealt with appropriately.

Melanoma metastatic to the mandible. Report of a case.

Metastasis of a tumor to the jaws can simulate an infection, but the presence of paraesthesia and loose teeth or inadequate response to treatment should alert the clinician to a more serious cause. A malignant melanoma metastatic to the jaws illustrates these points.