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Treatment of recurrent mandibular myxoma by curettage and cryotherapy after thirty years.

Rocha AC, Gaujac C, Ceccheti MM, Amato-Filho G, Machado GG - Clinics (Sao Paulo) (2009)

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Large-sized lesions may cause tooth dislodgement and cortical bone expansion., Since pain and hypoesthesia are not common, the lesion may reach a considerable size before the patient perceives its existence and seeks treatment... No cortical bone or tooth root reabsorbtion were seen... Thus, the lesion did not penetrate the periosteum, and was not contiguous with the alveolar mucosa (Figure 4)... An incisional biopsy was made and a histopathological examination of the tissue sample exhibited rounded, spindled, and stellate cells arranged in a loose, myxoid stroma with few collagen fibrils... These results confirmed the clinical hypothesis of odontogenic myxoma (Figure 5)... The conservative treatment established for the case of recurrent mandibular myxoma reported in this paper was lesion excision with curettage and cryotherapy, which contrasts with the radical treatment of block resection that is advised by most authors. ,,,– This is due to the invasive nature, large size, and recurrence history of this lesion... The criterion used to make the decision between a radical treatment (block resection) and a conservative treatment (excision, curettage, and cryotherapy) involved the presence of the remaining basal mandibular bone, which provided a framework for mandibular re-structuring... Other authors advise resection with a safety margin for any case due to the high recurrence rate of these lesions... The conservative management of myxomas by lesion excision and curettage with liquid nitrogen cryotherapy is an alternative to radical block resection... Although complications due to bone freezing may occur, they do not compromise the success of the treatment... The proposed therapy enhances patient rehabilitation by maintaining a satisfactory facial contour, thereby significantly minimizing the psychosocial impact to the patient... In addition, this treatment represents a less expensive intervention compared to more radical procedures.

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Panoramic radiograph 10 weeks after the surgery. Image suggesting pathological fractures in the left molar region. Teeth within the lesional area were extracted
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f7-13-le-0022: Panoramic radiograph 10 weeks after the surgery. Image suggesting pathological fractures in the left molar region. Teeth within the lesional area were extracted

Mentions: Postoperative complications included hypoesthesia in the mental region, suture dehiscence, and bone sequestra. A pathologic fracture occurred in this area 2 ½ months postoperatively (Figure 7). The sequestrated bone was removed 6 months after surgery, and the mandibular fracture was treated with local care (irrigation) and a diet consisting of soft foods. Five years after the surgical procedure, there were no radiographic or clinical signs of recurrence, and the patient’s ultimate rehabilitation was completed by the insertion of osteointegrated implants. Five titanium implants with bicortical anchors were placed in the mandible. After a four-month osteointegration period, an implant-supported denture was installed.


Treatment of recurrent mandibular myxoma by curettage and cryotherapy after thirty years.

Rocha AC, Gaujac C, Ceccheti MM, Amato-Filho G, Machado GG - Clinics (Sao Paulo) (2009)

Panoramic radiograph 10 weeks after the surgery. Image suggesting pathological fractures in the left molar region. Teeth within the lesional area were extracted
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2666483&req=5

f7-13-le-0022: Panoramic radiograph 10 weeks after the surgery. Image suggesting pathological fractures in the left molar region. Teeth within the lesional area were extracted
Mentions: Postoperative complications included hypoesthesia in the mental region, suture dehiscence, and bone sequestra. A pathologic fracture occurred in this area 2 ½ months postoperatively (Figure 7). The sequestrated bone was removed 6 months after surgery, and the mandibular fracture was treated with local care (irrigation) and a diet consisting of soft foods. Five years after the surgical procedure, there were no radiographic or clinical signs of recurrence, and the patient’s ultimate rehabilitation was completed by the insertion of osteointegrated implants. Five titanium implants with bicortical anchors were placed in the mandible. After a four-month osteointegration period, an implant-supported denture was installed.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Large-sized lesions may cause tooth dislodgement and cortical bone expansion., Since pain and hypoesthesia are not common, the lesion may reach a considerable size before the patient perceives its existence and seeks treatment... No cortical bone or tooth root reabsorbtion were seen... Thus, the lesion did not penetrate the periosteum, and was not contiguous with the alveolar mucosa (Figure 4)... An incisional biopsy was made and a histopathological examination of the tissue sample exhibited rounded, spindled, and stellate cells arranged in a loose, myxoid stroma with few collagen fibrils... These results confirmed the clinical hypothesis of odontogenic myxoma (Figure 5)... The conservative treatment established for the case of recurrent mandibular myxoma reported in this paper was lesion excision with curettage and cryotherapy, which contrasts with the radical treatment of block resection that is advised by most authors. ,,,– This is due to the invasive nature, large size, and recurrence history of this lesion... The criterion used to make the decision between a radical treatment (block resection) and a conservative treatment (excision, curettage, and cryotherapy) involved the presence of the remaining basal mandibular bone, which provided a framework for mandibular re-structuring... Other authors advise resection with a safety margin for any case due to the high recurrence rate of these lesions... The conservative management of myxomas by lesion excision and curettage with liquid nitrogen cryotherapy is an alternative to radical block resection... Although complications due to bone freezing may occur, they do not compromise the success of the treatment... The proposed therapy enhances patient rehabilitation by maintaining a satisfactory facial contour, thereby significantly minimizing the psychosocial impact to the patient... In addition, this treatment represents a less expensive intervention compared to more radical procedures.

Show MeSH
Related in: MedlinePlus