Complications of Zygomatic Implants: Our Clinical Experience with 4 Cases

Zigomatični implantati koriste se već gotovo dvadeset godina kao alternativa presađivanju kosti pri rehabilitaciji bezube i atropične maksile i pritom su postignuti zadovoljavajući klinički rezultati. Ipak, pacijentima liječenima tom tehnikom mogu se razviti ozbiljne komplikacije koje mogu ugroziti protetički rad. Četiri takva slučaja opisana su u ovom izvještaju – prvi s kožnom fistulom u zigomatično-orbitalnom području uzrokovanom aseptičnom nekrozom na apikalnom kraju implantata koja je liječena kirurškim uklanjanjem toga dijela; u drugom slučaju to je bio gubitak implantata zbog neuspjele osteointegracije pa je cijeli usadak uklonjen, a u trećem i četvrtom slučaju riječ je o periimplantitisu i djelomičnom uklanjanju implantata. Sve komplikacije liječene su bez ugrožavanja restauracije koja je ostala funkcionalna nakon odgovarajućih prilagodbi.Zygomatic implants have been used for rehabilitation of the edentulous atrophic maxilla as an alternative to bone grafting for almost two decades resulting in satisfactory clinical outcomes. However, the patients with edentulous atrophic maxilla treated using this technique may present serious complications that could put the prosthetic restoration at risk. Four cases are reported in this paper, one case with a cutaneous fistula in the left zygomatic-orbital area caused by aseptic necrosis at the apical part of the implant, which was treated with the surgical removal of this part, a second case with loss of the right zygomatic implant due to failure of osseointegration and two cases of periimplantitis that resulted in partial and complete removal of the implant, respectively. All patients who had complications were treated without compromising the restoration which remained functional after appropriately modified treatment

Primary tooth abscess caused by Mycobacterium bovis in an immunocompetent child

Bovine tuberculosis is a zoonotic disease, and although its incidence has dramatically decreased in developed countries where effective control measures are applied, it still remains a potential health hazard in the developing world. Tuberculosis of the oral cavity is extremely rare and is usually secondary to pulmonary involvement. We present the unusual case of an immunocompetent 6-year-old child residing in an urban area with primary oral tuberculosis due to Mycobacterium bovis, which was confirmed by the application of a molecular genetic approach. M. bovis belongs to Mycobacterium tuberculosis complex which comprises species with close genetic relationship, and for this reason, the use of new molecular techniques is a useful tool for the differentiation at species level of the closely related members of this complex

Intraosseous cystic lesions of the jaws in children: A retrospective analysis of 47 consecutive cases

Objectives. The aim was to review the characteristics and treatment approach in 47 cases of intraosseous cystic lesions of the jaws in children. Study design: Forty-three patients, 2-14 years old, with 47 cystic lesions of the jaws, were treated during the period 2000-2007. All cysts were surgically removed. No bone grafts were used and the teeth involved were preserved whenever possible. Removed tissues were examined histologically. Follow-up period ranged from 6 months to 7 years. Results. In 74.5% of the cases, cysts were enucleated, and in 17.0% they were marsupialized. Most commonly, the cysts were dentigerous (20, 42.6%), followed by eruption cysts, odontogenic keratocysts, and radicular cysts (10.6% each) and buccal bifurcation cysts (8.6%). Conclusion. Cystic lesions in children were found to be mainly of developmental origin. Treatment was surgical removal without interfering, when possible, with the development of the dentition. Surgical approach was usually enucleation and, to a lesser extent, marsupialization. ( Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 485-492

Management of Intraosseous Vascular Malformations of the Jaws in Children and Adolescents: Report of 6 Cases and Literature Review

Background: Intraosseous vascular malformations represent a rare clinical entity of the facial skeleton. The purpose of the current study was to present our experience in a Greek paediatric population and propose guidelines for the treatment of these jaws anomalies in children and adolescents. Methods: A retrospective study (from 2009 to 2014) was performed to investigate the features and management of the intraosseous vascular anomalies in a Greek paediatric population. Results: Six patients aged between 6 and 14 years were treated for intraosseous vascular malformations (4 venous and 2 arteriovenous) of the jaws. Five lesions were located in the mandible and one in the maxilla. In four lesions with pronounced vascularity superselective angiography, followed by embolization was performed. Individualized surgical treatment, depending on the size and vascularity of the lesions was applied in 4 patients. Conclusions: The intraosseous vascular malformations of the jaws may escape diagnosis in paediatric patients. A multidisciplinary approach is important for their safe and efficient treatment. Embolization is recommended for extended high-flow lesions, either preoperatively or as a first-line treatment, when surgery is not feasible without significant morbidity