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Owosho AA, Aguirre SE, Dayo AF, Omolehinwa TT, Shintaku WH. Radiographic Orofacial Findings of Systemic Diseases. Dent Clin North Am 2024; 68:409-427. [PMID: 38417998 DOI: 10.1016/j.cden.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article discusses the orofacial clinicoradiographic features of systemic diseases that manifest in the orofacial region. The systemic diseases discussed are grouped into the following: autoimmune diseases, endocrine diseases, bone diseases, hematologic diseases, syndromes, and malignancies. The radiographic manifestation ranges from radiolucent bony destruction, increased bone density, calcification, thinning of cortical plate, loss of trabeculation, missing teeth, and supernumerary teeth. It is imperative for clinicians to be cognizant of these findings, as they may be the first manifestation of these systemic diseases.
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Affiliation(s)
- Adepitan A Owosho
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Sarah E Aguirre
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adeyinka F Dayo
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Temitope T Omolehinwa
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Werner H Shintaku
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
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2
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Blackwell MC, Thakkar B, Flores A, Zhang W. Extracolonic manifestations of Gardner syndrome: A case report. Imaging Sci Dent 2023. [DOI: 10.5624/isd.20230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
- McKenzie C. Blackwell
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Bhushan Thakkar
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Andres Flores
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Wenjian Zhang
- Department of General Dentistry, East Carolina University School of Dental Medicine, Greenville, NC, USA
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Pacheco-Pereira C, Almeida FT, Acevedo AC, Geha H, Septer S, Friesen LR, Attard TM, Guerra ENS. A comparison of panoramic radiographic findings in patients with familial adenomatous polyposis and the general population: a multicenter study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:349-357. [PMID: 34758938 DOI: 10.1016/j.oooo.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Familial adenomatous polyposis (FAP) is a hereditable disorder characterized by early and unremitting development of intestinal polyps and extraintestinal manifestations requiring multidisciplinary surveillance. Herein we describe a multicenter cross-sectional analysis of the dento-osseous radiographic findings of patients with FAP from North and South America. STUDY DESIGN Groups I and II included individuals with FAP diagnosed by standard clinical criteria. Patients were paired with age- and sex-matched participants without FAP. Panoramic radiograph of both cohorts, including children and adults, were analyzed. RESULTS Of 114 panoramic radiographs, 38 were from patients with FAP, composed of group I (n = 22) and group II (n = 16), and 76 were from matched control participants. Evaluators had excellent agreement on key findings (intraclass correlation coefficient = 0.89). The prevalence of osseous anomalies was higher in adults (75%) than in children (65.4%). Dental anomalies were also higher in children with FAP with a prevalence of 15.4%. CONCLUSIONS We describe important and significant differences in the prevalence of dento-osseous anomalies in children compared with adult patients with FAP. These findings warrant careful consideration and may influence multidisciplinary management of the condition. Conversely, the presence of these abnormalities in pediatric dental patients even if not diagnosed with FAP should be borne in mind as possibly indicating de novo or unrecognized disease.
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Affiliation(s)
- Camila Pacheco-Pereira
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; Oral Maxillofacial Radiology Program, Comprehensive Dentistry, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA; Laboratory Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasilia, Brazil
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ana Carolina Acevedo
- Laboratory Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasilia, Brazil
| | - Hassem Geha
- Oral Maxillofacial Radiology Program, Comprehensive Dentistry, University of Texas Health Sciences at San Antonio, San Antonio, TX, USA
| | - Seth Septer
- Division of Gastroenterology, Hepatology & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Lynn Roosa Friesen
- Department of Corporate Clinical Research & Department of Research and Graduate Programs, University of Missouri, Kansas City School of Dentistry, Kansas City, MO, USA
| | - Thomas M Attard
- Division of Gastroenterology, Hepatology & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Eliete N S Guerra
- Laboratory Oral Histopathology, Health Sciences Faculty and Oral Care Center for Inherited Diseases, University of Brasilia, Brasilia, Brazil
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Dento-osseous anomalies in patients with familial adenomatous polyposis: A follow-up study. Clin Oral Investig 2020; 24:3501-3511. [DOI: 10.1007/s00784-020-03220-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/22/2020] [Indexed: 01/29/2023]
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Larsson Wexell C, Bergenblock S, Kovács A. A Case Report on Gardner Syndrome With Dental Implant Treatment and a Long-Term Follow-Up. J Oral Maxillofac Surg 2019; 77:1617-1627. [PMID: 30959012 DOI: 10.1016/j.joms.2019.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/26/2022]
Abstract
A case of Gardner syndrome (GS) in a 37-year-old woman is presented in which rehabilitation with dental implant treatment was followed for 7 years. The course of diagnostics and treatment is followed through an overview of 45 tissue biopsy and cytology samples during a period of 30 years. The patient was diagnosed with GS after a routine review of an oral panoramic radiograph presenting with multiple osteomas and multiple unerupted supernumerary teeth. Biopsy results and surgical procedures with histopathologic diagnoses from 1986 to 2016 are presented. Histologic analysis of the sampled jawbone showed a picture similar to an osteoid osteoma. The installed implant was functionally stable, with no clinical or radiographic events observed at yearly visits, for 7 years. In 1991, benign tumors appeared; in 2014, multiple adenomas were found in the small intestine and rectum. This case report shows the potential for dental implant treatment in a patient with GS.
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Affiliation(s)
- Cecilia Larsson Wexell
- Associate Professor and Senior Consultant in OMFS, Department of Oral and Maxillofacial Surgery, Skane University Hospital, Lund; Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Sibel Bergenblock
- Senior Consultant in Prosthodontics, Department of Prosthodontics, Public Dental Health Service, Sahlgrenska University Hospital-Mölndal, Mölndal, Sweden
| | - Anikó Kovács
- Associate Professor and Senior Consultant in General Pathology, Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Wnt/β-catenin signaling, which is activated in odontomas, reduces Sema3A expression to regulate odontogenic epithelial cell proliferation and tooth germ development. Sci Rep 2019; 9:4257. [PMID: 30862786 PMCID: PMC6414619 DOI: 10.1038/s41598-019-39686-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Accepted: 01/29/2019] [Indexed: 01/03/2023] Open
Abstract
Odontomas, developmental anomalies of tooth germ, frequently occur in familial adenomatous polyposis patients with activated Wnt/β-catenin signaling. However, roles of Wnt/β-catenin signaling in odontomas or odontogenic cells are unclear. Herein, we investigated β-catenin expression in odontomas and functions of Wnt/β-catenin signaling in tooth germ development. β-catenin frequently accumulated in nucleus and/or cellular cytoplasm of odontogenic epithelial cells in human odontoma specimens, immunohistochemically. Wnt/β-catenin signaling inhibited odontogenic epithelial cell proliferation in both cell line and tooth germ development, while inducing immature epithelial bud formation. We identified Semaphorin 3A (Sema3A) as a downstream molecule of Wnt/β-catenin signaling and showed that Wnt/β-catenin signaling-dependent reduction of Sema3A expression resulted in suppressed odontogenic epithelial cell proliferation. Sema3A expression is required in appropriate epithelial budding morphogenesis. These results suggest that Wnt/β-catenin signaling negatively regulates odontogenic epithelial cell proliferation and tooth germ development through decreased-Sema3A expression, and aberrant activation of Wnt/β-catenin signaling may associate with odontoma formation.
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Almeida FT, Pachêco-Pereira C, Porporatti AL, Flores-Mir C, Leite AF, De Luca Canto G, Guerra ENS. Oral manifestations in patients with familial adenomatous polyposis: A systematic review and meta-analysis. J Gastroenterol Hepatol 2016; 31:527-40. [PMID: 26331960 DOI: 10.1111/jgh.13149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM The oral manifestations of familial adenomatous polyposis (FAP) have been reported in the recent literature. Therefore, there has been growing interest in the characterization of the dento-osseous anomalies because they may precede colorectal cancer and may be used as a diagnostic marker. This systematic review and meta-analysis was performed to evaluate the published evidence for what are the oral manifestations of FAP and their frequency in affected individuals. METHODS The search was performed at Cochrane Library, EMBASE, LILACS, PubMed, Scopus, and Web of Science for articles published up to March 2015. A grey literature search was conducted through Google Scholar. Reference lists of the included articles and additional studies identified by expert were screened for potential relevant studies. The methodology of selected studies was evaluated using the risk of bias checklist of the Agency for Healthcare Research and Quality. RESULTS Twenty observational studies totalizing 1635 individuals affected by FAP met the inclusion criteria. Osseous, dental, and oral mucosa alterations were observed in FAP patients. The meta-analysis showed the frequency of osseous jaw lesions, and the dental anomalies were 65.35% and 30.48%, respectively, and two studies suggested that oral mucosa vascular density is a phenotypic manifestation in patients with FAP. Most of the studies were evaluated as moderate risk of bias. CONCLUSION The most frequent oral manifestation on FAP patients is osseous jaw alterations. In the future, well-designed studies are necessary to classify osseous and dental anomalies in order to demonstrate the true prevalence of each alteration separately.
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Affiliation(s)
| | - Camila Pachêco-Pereira
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada
| | - André Luís Porporatti
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.,Department of Prosthodontics, Section of Orofacial Pain, Bauru School of Dentistry, University of São Paulo, Bauru, SP,, Brazil
| | - Carlos Flores-Mir
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada
| | - André Ferreira Leite
- Oral Histopathology Laboratory, Health Sciences Faculty, University of Brasília, Brasília, Brazil
| | - Graziela De Luca Canto
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta,, Canada.,Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil
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Seehra J, Patel S, Bryant C. Gardner's Syndrome revisited: a clinical case and overview of the literature. J Orthod 2015; 43:59-64. [PMID: 25907321 DOI: 10.1179/1465313315y.0000000008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Gardner's syndrome (GS), a variant of familial adenomatous polyposis (FAP), remains a life-threatening condition of significant dental relevance. Clinicians can play an important role in the identification of this condition as the dental manifestations often precede the development of intestinal polyposis. This article describes a clinical case in which identification of the dental features of GS during routine orthodontic assessment resulted in the early diagnosis of this condition, which was previously unrecognised in a young female patient.
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Affiliation(s)
- Jadbinder Seehra
- a Department of Orthodontics , Kings College Dental Hospital , Bessemer Road, London SE5 9RS , UK
| | - Shruti Patel
- a Department of Orthodontics , Kings College Dental Hospital , Bessemer Road, London SE5 9RS , UK
| | - Catherine Bryant
- b Department of Oral Surgery , Kings College Dental Hospital , Bessemer Road, London SE5 9RS , UK
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Additional Detection of Multiple Osteomas in a Patient with Gardner's Syndrome by Bone SPECT/CT. Nucl Med Mol Imaging 2013; 47:297-8. [PMID: 24900131 DOI: 10.1007/s13139-013-0225-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/28/2013] [Accepted: 08/07/2013] [Indexed: 10/26/2022] Open
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Abstract
This article describes the clinical, radiographic, and pathologic features of tumors and tumorlike lesions affecting the bones of the head and neck region. Emphasis is placed on common bone lesions affecting the craniofacial skeleton, particularly those that occur with more frequency or those that are unique to this part of the skeleton. Several of these lesions pose a diagnostic challenge to the pathologist. To ensure that a correct diagnosis is rendered, it is of utmost importance that accurate and detailed clinical and radiographic information is available.
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Affiliation(s)
- Samir K El-Mofty
- Department of Pathology and Immunology, Washington University School of Medicine, 660 Euclid Avenue, Campus Box 8118, St Louis, MO 63110, USA
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11
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Wang XP, Fan J. Molecular genetics of supernumerary tooth formation. Genesis 2011; 49:261-77. [PMID: 21309064 DOI: 10.1002/dvg.20715] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 01/02/2011] [Accepted: 01/06/2011] [Indexed: 01/07/2023]
Abstract
Despite advances in the knowledge of tooth morphogenesis and differentiation, relatively little is known about the aetiology and molecular mechanisms underlying supernumerary tooth formation. A small number of supernumerary teeth may be a common developmental dental anomaly, while multiple supernumerary teeth usually have a genetic component and they are sometimes thought to represent a partial third dentition in humans. Mice, which are commonly used for studying tooth development, only exhibit one dentition, with very few mouse models exhibiting supernumerary teeth similar to those in humans. Inactivation of Apc or forced activation of Wnt/β(catenin signalling results in multiple supernumerary tooth formation in both humans and in mice, but the key genes in these pathways are not very clear. Analysis of other model systems with continuous tooth replacement or secondary tooth formation, such as fish, snake, lizard, and ferret, is providing insights into the molecular and cellular mechanisms underlying succesional tooth development, and will assist in the studies on supernumerary tooth formation in humans. This information, together with the advances in stem cell biology and tissue engineering, will pave ways for the tooth regeneration and tooth bioengineering.
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Affiliation(s)
- Xiu-Ping Wang
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115, USA.
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13
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Lee BD, Lee W, Oh SH, Min SK, Kim EC. A case report of Gardner syndrome with hereditary widespread osteomatous jaw lesions. ACTA ACUST UNITED AC 2009; 107:e68-72. [PMID: 19157925 DOI: 10.1016/j.tripleo.2008.10.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 07/24/2008] [Accepted: 10/21/2008] [Indexed: 11/19/2022]
Abstract
Gardner syndrome (GS) is an abnormality of familial adenomatous polyposis accompanied by characteristic jaw lesions. Gardner syndrome intestinal polyps have a 100% risk of undergoing malignant transformation; consequently, early identification and surgical intervention of the disease are important to prolong the life of the patient. We present a case of GS in a 55-year-old woman. Familial adenomatous polyposis, osteomatous jaw and ocular lesions, several dental abnormalities, and an abdominal desmoid tumor are the characteristic features of this case. This case demonstrates the presence of unusual, widespread, hereditary, osteomatous jaw lesions that caused diagnostic confusion with familial gigantiform cementoma.
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Affiliation(s)
- Byung Do Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan City, Korea.
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14
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Groen EJ, Roos A, Muntinghe FL, Enting RH, de Vries J, Kleibeuker JH, Witjes MJH, Links TP, van Beek AP. Extra-intestinal manifestations of familial adenomatous polyposis. Ann Surg Oncol 2008; 15:2439-50. [PMID: 18612695 PMCID: PMC2518080 DOI: 10.1245/s10434-008-9981-3] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Revised: 05/07/2008] [Accepted: 05/08/2008] [Indexed: 12/20/2022]
Abstract
Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited disorder, which results from a germ line mutation in the APC (adenomatous polyposis coli) gene. FAP is characterized by the formation of hundreds to thousands of colorectal adenomatous polyps. Although the development of colorectal cancer stands out as the most prevalent complication, FAP is a multisystem disorder of growth. This means, it is comparable to other diseases such as the MEN syndromes, Von Hippel-Lindau disease and neurofibromatosis. However, the incidence of many of its clinical features is much lower. Therefore, a specialized multidisciplinary approach to optimize health care-common for other disorders-is not usually taken for FAP patients. Thus, clinicians that care for and counsel members of high-risk families should have familiarity with all the extra-intestinal manifestations of this syndrome. FAP-related complications, for which medical attention is essential, are not rare and their estimated lifetime risk presumably exceeds 30%. Affected individuals can develop thyroid and pancreatic cancer, hepatoblastomas, CNS tumors (especially medulloblastomas), and various benign tumors such as adrenal adenomas, osteomas, desmoid tumors and dental abnormalities. Due to improved longevity, as a result of better prevention of colorectal cancer, the risk of these clinical problems will further increase. We present a clinical overview of extra-intestinal manifestations, including management and treatment options for the FAP syndrome. Furthermore, we provide recommendations for surveillance of FAP complications based on available literature.
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Affiliation(s)
- Emma J Groen
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, De Brug 4.069, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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Wijn MA, Keller JJ, Giardiello FM, Brand HS. Oral and maxillofacial manifestations of familial adenomatous polyposis. Oral Dis 2007; 13:360-5. [PMID: 17577321 DOI: 10.1111/j.1601-0825.2006.01293.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with familial adenomatous polyposis (FAP) develop multiple premalignant colorectal adenomas. Untreated, one or more of these polyps will progress to colorectal carcinoma in middle-aged adults. Extra-intestinal manifestations of FAP are frequently observed and this combination has been called Gardner's syndrome. Oral and maxillofacial symptoms of FAP include an increased risk of jaw osteomas, odontomas and supernumerary or unerupted teeth. Early diagnosis of FAP is crucial and may be life saving. As oral signs usually precede gastrointestinal symptoms, the dentist may play an important role in the diagnosis of FAP.
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Affiliation(s)
- M A Wijn
- Departments of Oral-Maxillofacial Surgery and Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Larrea-Oyarbide N, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C. Osteomas of the craniofacial region. Review of 106 cases. J Oral Pathol Med 2007; 37:38-42. [DOI: 10.1111/j.1600-0714.2007.00590.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fonseca LC, Kodama NK, Nunes FCF, Maciel PH, Fonseca FA, Roitberg M, de Oliveira JX, Cavalcanti MGP. Radiographic assessment of Gardner's syndrome. Dentomaxillofac Radiol 2007; 36:121-4. [PMID: 17403893 DOI: 10.1259/dmfr/18554322] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The detection of osteomas in the maxillofacial region may be the initial clinical finding in Gardner's syndrome (GS). The most common location of osteomas is in the skull, but the lesion can also occur in the jaws. We present a case of a 47 year old male patient with GS who was referred for radiological evaluation. Extraoral examination revealed an epidermoid cyst and the patient had a history of intestinal polyps. A panoramic radiograph demonstrated numerous osteomas and diffuse sclerosis of the mandible, and compound odontomas with impacted teeth. CT scan allowed the localization and extension of the osteomas, and showed other sites in the maxillofacial region as well. CT images also revealed a different behaviour of osteoma, invading the mandibular canal.
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Affiliation(s)
- L C Fonseca
- Department of Radiology, College of Dentistry, University of São Paulo, São Paulo, Brazil
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Firat D, Sirin Y, Bilgic B, Ozyuvaci H. Large central osteoma of the maxillary antrum. Dentomaxillofac Radiol 2005; 34:322-5. [PMID: 16120885 DOI: 10.1259/dmfr/15263929] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of this report is to describe a case presenting with complaints of orbital pain, altered facial sensation, nasal obstruction and unilateral spontaneous nose bleeding. Panoramic radiography and computerized tomography disclosed a large pedunculated heterogeneous mineral opacity with two impacted molar teeth invading the maxillary sinus. The patient was operated on under general anaesthesia. Microscopic examination of the surgical specimen revealed relatively dense, compact bone with sparse marrow tissue that was diagnosed as osteoma. Clinical characteristics and biological behaviour of this lesion were evaluated with special regard to the reliability of imaging modalities and surgical procedures.
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Affiliation(s)
- D Firat
- Istanbul Universitesi, Dishekimligi Fakultesi, Ağiz-Diş, Cene Hast., Ve Cerrahisi Anabilim Dali, Capa, Istanbul, Turkey.
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Affiliation(s)
- Anders Merg
- Roswell Park Cancer Center, Buffalo, New York, USA
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Baykul T, Heybeli N, Oyar O, Doğru H. Multiple huge osteomas of the mandible causing disfigurement related with Gardner's syndrome: case report. Auris Nasus Larynx 2003; 30:447-51. [PMID: 14656576 DOI: 10.1016/s0385-8146(03)00063-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
As osteomas of the bones including the jaws may be the initial symptom or clinical finding in the Gardner's syndrome, this entity should always be included in the differential diagnosis. A 20-year-old boy was referred to our clinic from another medical center. Extra-oral examination of the patient revealed an obvious asymmetry and disfigurement of the left mandibular corpus, angle and ramus. A panoramic radiograph revealed two huge osteomas at the angle, ramus and two smaller osteomas at the inferior border of the mandible. At the same time, there were an impacted canine and premolar. Diffuse sclerosis of the whole mandible was also seen. Upon the suspicion of Gardner's syndrome, barium passage radiographs of the intestine were requested and multiple polyps were observed. All of these findings led us to the diagnosis of Gardner's syndrome. The oral and maxillofacial surgeon and the dentist needs to be aware of the components of this entity because manifestations in the head and neck including epidermoid cysts, osteomas, odontomas, exostoses, supernumerary and impacted teeth are common. At the same time, osteomas causing disfigurement on the face related with Gardner's syndrome with increased uptake in scintigraphic examination should be treated by surgical excision of the lesions.
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Affiliation(s)
- Timuçin Baykul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, S. Demirel University, Iskender mahallesi, 121. cadde, 49/4, 32000, Isparta, Turkey.
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Affiliation(s)
- Bohdan Bybel
- Department of Molecular and Functional Imaging, Cleveland Clinic Foundation, London, Ontario, Canada.
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23
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Lew D, DeWitt A, Hicks RJ, Cavalcanti MG. Osteomas of the condyle associated with Gardner's syndrome causing limited mandibular movement. J Oral Maxillofac Surg 1999; 57:1004-9. [PMID: 10437730 DOI: 10.1016/s0278-2391(99)90026-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- D Lew
- Department of Oral and Maxillofacial Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
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Abstract
Familial adenomatous polyposis (FAP) is an autosomal dominant condition resulting in the development of more than 100 adenomatous polyps in the large bowel. In addition, a number of extracolonic manifestations of the condition may occur. Recently, increasing knowledge relating to the extracolonic abnormalities, and localization and sequencing of the gene for FAP, have had important implications for screening and long-term follow-up of those affected. In this review the natural history of the disease and the extracolonic manifestations associated with it are considered. Surgical management and advances in understanding at a molecular level are discussed, as well as the problems relating to screening for FAP and the implications of the new knowledge.
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Affiliation(s)
- W J Campbell
- University Department of Surgery, Belfast City Hospital, UK
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