Search Results (8)

Background and Clinical Significance: Odontogenic myxoma (OM) is a rare benign neoplasm of the jawbones characterized by spindle-shaped cells embedded in a myxoid stroma. Despite its benign histological nature, it demonstrates locally aggressive behavior, significant invasiveness, and a high risk of recurrence. OM ranks as the third most common odontogenic tumor after odontoma and ameloblastoma. It affects both sexes and occurs more frequently in the mandible than in the maxilla, typically during the second to fourth decades of life. Macroscopically, OM is non-encapsulated, whitish-gray, and gelatinous. Radiographically, it usually presents as a radiolucent lesion with fine bony trabeculae, producing a characteristic “tennis racket” appearance. Case Presentation: We report a case of a 27-year-old male diagnosed with maxillary odontogenic myxoma measuring 2.3 × 1.7 cm. Clinical, radiographic, and histopathological findings were evaluated, and the lesion was treated conservatively by surgical enucleation and curettage. Results: The surgical procedure was completed without complications. Histopathological analysis confirmed the diagnosis of odontogenic myxoma. The patient showed satisfactory postoperative healing, and no evidence of recurrence was observed during a 10-month follow-up period. Conclusions: Although odontogenic myxoma is benign, its locally aggressive nature and recurrence potential require accurate diagnosis and appropriate management. Conservative treatment by enucleation and curettage may be effective for small, well-defined lesions, provided that careful long-term follow-up is maintained to monitor for recurrence. Full article

The occurrence of cysts and tumors in pediatric patients varies across different age groups. Follicular and dentigerous cysts are among the most common lesions. However, typical odontogenic tumors in juvenile patients are not frequently observed. Early stages of cyst and odontogenic tumor development might exhibit some similar characteristics due to the presence of unerupted teeth or their relationship with various stages of tooth formation and eruption. Many small lesions are discovered accidentally on routine orthopantomography (OPG), while the bigger ones manifest themselves as bone swelling, cortical perforation, or displacement and mobility of teeth. Each odontogenic tumor has characteristic clinical and radiological features. Biopsy of larger lesions, or incisional biopsy of smaller lesions, allows detailed histopathological evaluation to determine tumor type and growth behavior and guide appropriate treatment planning. In some cases, atypical signs on OPGs, like asymmetry in dental follicles, occurrence of round or oval bone lesions near impacted or retained teeth, and visibility of irregular radiolucent, radiopaque, or mixed jawbone lesions, might suggest the occurrence of some possible odontogenic tumor in juvenile patients. Each case should be handled individually. In this case, we demonstrate how atypical appearances of dental follicles on panoramic radiographs may not correspond with cone-beam computed tomography findings and may indicate the early stages of odontogenic myxoma in a juvenile patient. Full article

Background: Odontogenic myxoma (OM) is a rare, benign, but locally aggressive tumor of odontogenic mesenchymal origin. This study aims to expand current knowledge by integrating a concise literature review with a detailed case report of a surgically complex pediatric OM, treated using a biologically advantageous reconstructive technique. Methods: In this study, we report the case of an eight-year-old girl presenting with a large OM that caused complete disruption of the architecture of the left hemimandible. Due to the tumor’s size and bone involvement, radical resection was necessary. A modified extraoral facelift approach was employed to ensure adequate surgical access while avoiding intraoral incisions and minimizing visible scarring. Immediate mandibular reconstruction was performed using an autologous costochondral graft. Discussion: Although infrequently used in modern surgical practice, the costochondral graft offers unique advantages in pediatric patients due to its inherent growth potential and capacity for long-term biological integration. In this case, the graft allowed restoration of mandibular continuity and form with minimal donor site morbidity, demonstrating its viability even today. Conclusions: This case underlines the importance of tailored reconstructive strategies in pediatric OM. The costochondral graft provided excellent functional and esthetic results, with four-year follow-up confirming stable anatomical remodeling and bone regeneration. Full article

Odontogenic myxoma (OM) is a rare, benign intraosseous tumor that arises from the dental follicle, dental papilla, or periodontal ligament. It typically affects the mandible, maxilla, and sinuses, more frequently in women than men. The histopathology of OM is characterized by a myxoid stroma with varying degrees of collagenization and spindle cells. Treatment is surgical, but there are no standardized guidelines. Available options include enucleation and curettage, with conservative approaches offering better aesthetics and functionality but a higher recurrence risk. This case report aims to discuss a rare presentation of OM in the anterior part of the mandible of a 22-year-old female patient with Hashimoto’s thyroiditis and idiopathic thrombocytopenic purpura. The patient presented with painless swelling and tooth mobility in the symphysis region. Radiographic evaluation revealed a unilocular lesion extending from the left second incisor to the right first incisor, with no root resorption. Histopathological analysis confirmed the OM diagnosis. Due to the patient’s young age and the size of the lesion, a conservative treatment approach was chosen, with the potential for future implant-prosthodontics rehabilitation. The case underscores the importance of thorough clinical, radiological, and histopathological assessment to ensure accurate diagnosis and management of OM. Long-term follow-up is essential due to the increased risk of recurrence in younger patients. Full article

Background/Objectives: Odontogenic tumors in pediatric patients are uncommon; among all, the intraosseous occurrence of odontogenic myxoma is very rare, accounting for almost 8.5–11.6% of all odontogenic tumors in children. The radiological appearance is highly variable and is often responsible for the diagnostic delay and treatment. Methods: We report a case of odontogenic myxoma occurring in the posterior mandible of a 12-year-old female, found on a panoramic radiograph performed for the delayed eruption of the second inferior molar, treated by conservative surgery. A comprehensive analysis of the literature was also carried out. Results: The radiological features of the presented case were unique, as the lesion was encompassed within the uncompleted (developing) dental crown still unerupted, as confirmed by the macroscopic appearance. Then, the differential diagnosis included odontogenic fibroma, immature dental pulp or follicle from a developing tooth, and ameloblastic fibrodontoma. The histological examination led to the final diagnosis of odontogenic myxoma. As for the literature analysis, after a PRISMA-based selection of the papers, a total of 23 articles (case reports and case series on odontogenic myxomas in pediatric patients, a total of 33 cases) were finally selected and studied; all the pertinent data are widely discussed within the paper. Conclusions: The current case highlights the importance of the radiological investigation in pediatric patients when a delayed eruption lasts for several months, leading to an early diagnosis necessary to avoid more aggressive surgical therapies and possible recurrence; data from the literature about site of occurrence, sex, age, kind of surgical procedure, and recurrence rate are discussed too. Full article

Background/Objectives: Computer-assisted mandibular reconstruction requires sophisticated technical expertise alongside surgical knowledge. This study aims to establish and validate an efficient collaborative protocol between oral and maxillofacial surgeons and bioengineers for virtual surgical planning in mandibular reconstruction. Methods: We developed a structured protocol with four sequential phases: (1) generation of 3D models from CT data, (2) virtual resection planning, (3) reconstruction design, and (4) surgical guide fabrication. Protocol efficiency was assessed through seven simulation trials measuring planning duration and required revisions. Clinical validation was performed in four mandibular reconstruction cases. Accuracy was evaluated by comparing virtual surgical plans to postoperative outcomes using 3-matic 13.0 software analysis. Results: Protocol implementation showed consistent efficiency across simulations with a mean planning duration of 2.86 working days (SD = 1.35). Only two of seven simulations required design revisions. Clinical application in four cases (three ameloblastomas, one odontogenic myxoma) demonstrated high precision with a mean virtual-to-actual discrepancy of 0.90 mm (SD = 0.34). Successful reconstructions were achieved across varying defect spans (29–53 mm) using both bicortical deep circumflex iliac artery (DCIA) flaps and monocortical iliac block bone grafts. The collaborative workflow resulted in optimized surgical guide design, reduced planning iterations, and improved surgical precision. Conclusions: The established surgeon–bioengineer collaborative protocol enhances the efficiency and accuracy of computer-assisted mandibular reconstruction while making advanced surgical planning techniques more accessible. While initial results are promising, future studies with larger patient cohorts and extended follow-up periods are needed to fully validate the protocol’s long-term benefits and broader applicability. Full article

Odontogenic tumors (OTs) are distinct conditions that develop in the jawbones, exhibiting diverse histopathological features and variable clinical behaviors. Unfortunately, the literature on this subject in Saudi Arabia remains sparse, indicating a pressing need for more comprehensive data concerning the frequency, demographics, treatment modalities, and outcomes of OTs. Objectives: The study aims to evaluate the frequency, demographic features, treatment, and outcomes of OTs across three tertiary medical centers. Methods and Material: OT cases were identified in King Abdulaziz Medical City (KAMC), King Fahad Medical City (KFMC), and Prince Sultan Military Medical City (PSMMC) from January 2010 to December 2021. Results: Ninety-two OT cases were identified from the anatomical pathology laboratories of three tertiary hospitals. KFMC contributed the highest number of cases (43.5%), followed by KAMC (30.4%) and PSMMC (26.1%). The median age of OT patients was 29 years (range: 5–83), with males representing more than half of the patients (56.5%). The mandible was the most frequent site of OT occurrence (72.5%), with ameloblastoma being the predominant OT (63.0%), followed by odontoma (19.5%). Among the treatment modalities, bone resection was employed the most (51.0%), followed by enucleation (25.6%). Notably, 11.5% of OT cases with available follow-up data exhibited recurrence, with ameloblastoma accounting for eight recurrent cases. Conclusions: Although OTs are relatively common in the jaws, they are rare in anatomical pathology laboratories and the general population. This study contributes valuable insights into the epidemiology characteristics, treatment trends, and recurrence rates of OTs in Saudi Arabia. Full article

Myxomas are mostly seen in the 2th and 3rd decades. They rarely occur in childhood and maxillofacial region is rarely involved. The recurrence incidence is high. We report this unusual case occurring in a 9-year-old girl in the maxillofacial region and recurrence four months after initial treatment. Full article