• 沒有找到結果。

Innocuous convexities in the lingual cortex of the mandible

N/A
N/A
Protected

Academic year: 2022

Share "Innocuous convexities in the lingual cortex of the mandible"

Copied!
4
0
0

加載中.... (立即查看全文)

全文

(1)

口腔病理科 On-Line KMU Student Bulletin

- 1 -

原文題目(出處): Anterior lingual mandibular bone cavity as a diagnostic challenge: Two case reports. J Oral Maxillofac Surg 2010;68:201-4

原文作者姓名: Voss P, Marc Metzger C, Schulze D, Loeffelbein DJ, Pautke C, Hohlweg-Majert B

通訊作者學校: University Hospital Freiburg, Freiburg, Germany.

Technische Universität München, Munich, Germany 報告者姓名(組別): 許璧伃(Intern D組)

報告日期: 99/01/04

內文:

Introduction Stafne bone cyst

1. Well-demarcated radiolucency in the posterior mandibular angle.

2. Also known as static bone cyst, latent bone cyst, lingual mandibular bone cavity, mandibular embryonic defect, idiopathic bone concavity of the mandible, developmental submandibular gland defect of the mandible.

3. Innocuous convexities in the lingual cortex of the mandible.

4. Regular salivary gland tissue was the most histologic finding. Muscle, fibrous connective tissue, blood vessels, fat, or lymphoid tissue were also found in the lesion occasionally.

5. One theory suggested that part of the submandibular gland was entrapped in the lingual mandibular cortex.

6. The incidence ranges from 0.1% to 1.3%.

7. Richard and Ziskind in 1957 first found the Stafne bone cavity in the premolar region. The sublingual gland or aberrant salivary gland tissue has also been associated with this bony cavity in the anterior mandible.

8. The diagnosis of Stafne bone cavity is difficult on plain radiographs; and endodontic treatment, bone trephining and bone exploration may result from and incorrect diagnosis.

Object

To describe 2 new cases of Stafne bone cavity in the anterior mandible and to discuss the differential diagnosis process. Here introduces cone-beam computed tomography as a suitable noninvasive diagnostic and follow-up modality for these cases.

Case report Case 1:

¾ 58-yeal old male was noticed a sharply bordered unilateral radiolucency in the mandible by his dentist

¾ No significant history and symptom

¾ Lesion was located in the edentulous region between the lower right canine and the first molar and appeared to have no relation to the adjacent teeth

¾ This 1.5 x 3 cm lesion seemed to be associated with the mandibular canal

(2)

口腔病理科 On-Line KMU Student Bulletin

- 2 -

¾ Cone-beam computed tomography showed a lingual osteolysis, interrupting the lingual compact bone and affecting the mandibular canal with only

poorly-defined margin

¾ Histologic examinations shows a mixed salivary gland tissue with a slightly chronic infection in the area of the ducts and periducatal fibrosis

Case 2

¾ 50-year-old female

¾ No special dental or medical history

¾ A 20 x 15 mm radiolucency was found in the anterior mandible appearing to relate to adjacent teeth on a panoramic radiograph and periapical radiograph during routine dental

examination

(3)

口腔病理科 On-Line KMU Student Bulletin

- 3 -

¾ No abnormal findings and all teeth in the region responded within normal limits to the temperature pulp test

¾ Differential diagnosis were oeteoporotic focal defect of the marrow, apical granuloma, residual cyst or latent bone cyst

¾ An occlusal radiograph and ultrasound did not provide further information, so cone-beam computed tomography was performed

¾ A 20-mm-wide and 15-mm-long bony impression on the lingual side of the anterior mandible, which did not have any relation to an adjacent tooth

¾ A follow-up radiograph taken 5 months later did not show any alteration of the radiolucency. Therefore, no invasive therapy was performed on this patient.

Discussion

1. Ectopic salivary gland tissue: the lateral and posterior neck, tongue, middle ear, thyroid, pituitary gland, and mandible.

2. The inclusion of salivary gland tissue in the mandible is a rare phenomenon, which is most commonly seen in the posterior region and more unusually in the anterior mandible (0.009% to 0.3%).

3. Male patients seem to be more often affected (approximately 80%), with a peak in their fifth and sixth decades.

4. Hypotheses put forward suggest that the defect is congenital or develops through pressure resorption. The first theory suggests that part of the

(4)

口腔病理科 On-Line KMU Student Bulletin

- 4 -

salivary gland becomes entrapped during the development and ossification of the mandible.

5. Asymptomatic, non-progressive, and rarely palpated

6. Not all bone cavities will be well-demarcated impressions with a sclerotic border. Because a relation to the dental roots on plain radiographs is frequent in the anterior mandible, the differential diagnosis includes a periapical granuloma or radicular cyst; equally a keratocyst, an odontogenic tumor, or an idiopathic bone cavity may be unusual but possible considerations

7. Although sialography is helpful in doubtful posterior cases, it is

impracticable and rarely effective in anterior cases due to the presence of many accessory Bartholin ducts adjoining the sublingual gland in the anterior mouth floor so that it gives little information on the submandibular gland

8. Several investigators have described the use of computed tomography or magnetic resonance imaging to specify the diagnosis, especially in the anterior case

9. This article recommend cone-beam computed tomography—a rapidly developing radiographic 3-dimensional imaging technique—to confirm the diagnosis.

10. In most cases, no histopathology should be required and no treatment is indicated if 3-dimensional radiologic screening shows a Stafne cavity.

Nevertheless, regular follow-ups are recommended to identify any changes.

題號 題目

1 Which description about Stefne bone cyst is incorrect?

(A) It is also named mandibular embryonic defect.

(B) It is common that patient go for help when a radiolucency in a radiograph was found at a routine dental examination because in most cases Stafne bone cyst is asympomatic.

(C) Stafne bone cyst shows male predilection and is most seen in posterior mandibular area.

(D) Stafne bone cyst is distinguishable about the relationship with mandibular canal in a plain radiograph.

答案(D) 出處:Anterior Lingual Mandibular Bone Cavity as a Diagnostic Challenge: Two Case Reports (J Oral Maxillofac Surg 68:201-204 2010)

題號

題目

2 Which radiographic examination can be used to help to diagnosis Stafne bone cyst?

(A) Panoramic radiograph

(B) Sialography

(C) MRI

(D) Cone-beam computed tomography 答案

(ABCD )

出處:Oral and maxillofacial pathology p.23-p.24

參考文獻

相關文件

Clinical examination of the oral cavity revealed expansion of buccal and lingual cortices of the anterior region of the mandible, covered by ulcerated..

 Stage 3 Exposed ⁄ necrotic bone in patients with pain, infection, and one or more of the following: exposed and necrotic bone extending beyond the region of alveolar bone

Intraorally, a large area of exposed and seemingly nonvital (black discoloration) bone in the left parasymphysis and body of the mandible, adjoining left lateral border of

Focal osteoporotic bone marrow defect was considered as a differential diagnosis based on age, site, clinical and radiographic findings7. Histopathological examination

Dental panoramic view relieved extensive bone resorption of bilateral mandibular angles and total left condylolysis.. Extensive bone resorption of bilateral mandibular angles

In the present case, we initially did not consider the lesion to be malignant. On radiographic examination, remarkable bone destruction and swelling of the left side of the

Measurements of canine, first premolar, second premolar, first molar and second molar regions were taken at following levels: cortical plate thickness at the level of the midpoint

Another feasible option can be image‑guided PAIR of scolecidals method for percutaneous treatment of hydatid cyst of parotid gland, [11] have been reported as effective procedure