COVID-19-Associated Maxillary Osteomyelitis: A Case Report

Objectives Mucormycosis, a lethal opportunistic infection, is associated with high rates of morbidity and mortality. The pathogenesis of this disease appears to be multifactorial, with numerous factors contributing to its onset and progression, particularly in relation to COVID-19 infection. Case The presented case was a 41-year-old male who had a history of COVID-19 infection and had received high-dose corticosteroid therapy. He presented with a painless, extensive necrotic lesion on the right maxilla. Conclusion A biopsy confirmed the diagnosis of maxillary mucormycotic osteomyelitis associated with COVID-19. Overall, understanding this severe infection is crucial for accurate diagnosis and prompt treatment

A large asymptomatic multilocular radiolucent lesion of the mandible

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Evaluation of Cyclin D1 Expression in Aggressive and Nonaggressive Central Giant Cell Granuloma of the Jaws

Statement of the Problem: Central giant cell granuloma of the jaws is comprised of two types namely aggressive and nonaggressive. Controversy exists regarding the histogenesis of this lesion. Up to now, there are no reliable histologic or molecular methods to differentiate aggressive from nonaggressive central giant cell granuloma of the jaw. Moreover, because of different treatment of two groups, correct diagnosis is needed. Purpose: The purpose of this study was to evaluate and compare the expression of cyclin D1 between aggressive and nonaggressive central giant cell granulomas of the jaws. Materials and Method: This retrospective study was performed on 16 paraffin blocks of aggressive central giant cell granuloma, and 16 nonaggressive central giant cell granulomas from Shahid Beheshti Oral Pathology Department and evaluated the expression of cyclin D1 on giant cells and mononuclear cells of the lesions. T-test was used for quantitative evaluation and comparison of cyclin D1 expression between two groups. Results: Overexpression of cyclin D1 in giant cells and mononuclear cells of the lesions of both groups was apparent, but no significant statistical difference was seen. Cyclin D1 positivity was seen predominantly in the nuclei of giant cells. When a giant cell was positive, all the nuclei showed immunoreactivity. In each group mean percentage of the positive giant cells were higher than positive mononuclear cells and significant statistical difference (p= 0.000) was seen between them. Conclusion: Probably overexpression of cyclin D1 implicates in the pathogenesis of the central giant cell granulomas but it seems that this protein could not be used as a marker for identifying the clinical behavior of these lesions. The term giant cell lesion (GCL) describes a group of intraosseous nonodontogenic benign lesions containin

A Large Orthokeratinized Odontogenic Cyst of the Maxilla: A Rare Case Report

Objectives Orthokeratinized odontogenic cysts (OOCs) are relatively uncommon odontogenic cysts, lined by an orthokeratinized epithelium. These cysts show different clinical behaviors from the more common odontogenic keratocysts (OKCs), and it is important to distinguish these two types of cysts. Commonly, OOCs manifest as well-defined, unilocular, radiolucent lesions, with a high frequency in the mandibular region. In this case report, we aimed to describe a large maxillary OOC with prominent tooth displacement. Case The patient was a 14-year-old boy with significant painless swelling in the upper jaw. The panoramic radiograph revealed a well-defined, unilocular radiolucent area from midline to the first right maxillary molar with prominent tooth displacement. The lesion was completely excised under local anesthesia. The histopathological sections demonstrated a cystic lesion lined by an orthokeratinized stratified squamous epithelium with a prominent granular cell layer. Conclusion Based on the present results, OOCs can be large in size and may be characterized by ballooning expansion and tooth displacement. Therefore, knowledge of the clinical and radiographic features of these uncommon odontogenic cysts can facilitate an accurate diagnosis

Unusual microscopic changes of Ameloblastic Fibroma and Ameloblastic Fibro-odontoma : a systematic review

Ameloblastic fibroma (AF) and ameloblastic fibro-odontoma (AFO) are uncommon benign mixed odontogenic neoplasms. Although unusual microscopic changes including hybrid tumors have been documented in publications, their clinical outcome prediction and treatment modality selection are still challenging due to scarcity. Objective: Analysis of AF/AFO?s unusual microscopic variants in order to improve histopathologic diagnosis and to help clinicians in making informed treatment choices. An electronic search was performed in PubMed?s database using keywords: ?ameloblastic fibroma?, ?ameloblastic fibroodontoma?, ?ameloblastic fibro-odontoma?. The search scheme was limited to articles in English, dated ?January 1998? to ?October 2018?, with full texts (case reports and series) and human studies. Eligibility criteria included publications having enough clinical, radiological, and histological data to confirm their diagnosis. Age, sex, lesions? location, radiologic features, signs, symptoms, treatment approaches, and recurrences were recorded and analyzed. In this systematic review, 11 articles (reporting 14 cases) were selected. Patients? mean age was 13.75 years (male/female = 1.8). The posterior region of the mandible was the lesions? commonest location (57.14%). Swelling was reported in 78.57% of the cases, pain in 28.57% but 21.42% were asymptomatic. Radiolucent unilocular appearance was the commonest radiographic feature, but 28.57% of the cases showed a mixed radiolucent-radiopaque appearance. Other reported radiographic findings were impacted tooth (78.57%), root resorption (28.57%), tooth mobility (35.71%), and cortical perforation (14.28%). No recurrences were reported. Calcifying odontogenic cyst (COC) was the commonest lesion associated with AF/AFO (53.33%). Unicystic ameloblastoma and cystic changes without prominent epithelial lining were other reported hybrid lesions. Reported microscopic variations were pigmentation and ghost cell differentiation. COC was the commonest lesion associated with AF/AFO. Although COC commonly occurs in the jaws? anterior region, hybrid cases were more common in the posterior area. No malignant transformations were reported. The treatment modality is mostly chosen based on the lesion?s most aggressive part

Oral Granular Cell Tumor: A Case Report with Emphasis on Pseudoepitheliomatous Hyperplasia in Oral Lesions

A granular cell tumor (GCT) is an unusual benign mesenchymal neoplasm with Schwann cells origin. The most common site is the dorsum of the tongue. It has a striking tendency to occur in females and is more frequent in adult patients. GCT typically shows an asymptomatic, slow-growing, single nodule. Histopathologically, it reveals a proliferation of polygonal cells with granular cytoplasm penetrating the adjacent muscles. In some cases, the overlying epithelium demonstrates pseudoepitheliomatous hyperplasia (PEH), which can complicate its precise diagnosis and may mimic squamous cell carcinoma (SCC). This paper presents a 58-year-old woman with a chief complaint of painless mass on the dorsal of the tongue for two years. The lesion was pink and circumscribed with firm consistency measuring 1×1cm. The surface of the lesion was intact. Microscopic examination demonstrated unencapsulated sheets of large, polygonal cells with abundant eosinophilic, granul-ar cytoplasm, and vesicular nuclei. The overlying epithelium showed florid PEH and keratin pearl formation. S100 protein was positive diffusely. The diagnosis of oral GCT was made. Though GCT is a non-aggressive lesion, it may be confused with SCC due to florid PEH and keratin pearl formation. Although PEH is a neglected topic among oral patholog-ists, it is of great importance in the field of research. Diagnosis can sometimes be problematic because they mimic other lesions. The pathogenesis of PEH is still uncertain. Therefore, familiarity with these characteristics and determining the cause of the PEH leads to correct treatment. This article intends to raise the insight of oral pathologists about PEH in oral lesions

Metastatic Adenocarcinoma of Mandible with Unknown Primary Origin (CUP Syndrome): A Rare Case Report

Metastatic lesions of the jaws are a diagnostic challenge because of their scarcity and uncharacteristic clinical-radiographic features. Carcinoma of unknown primary origin (CUP) is characterized by the existence of metastatic disease with no recognized primary neoplasm after a comprehensive work-up. CUP shows a poor prognosis with limited treatment choices. This paper presents a 64-year-old male with a chief complaint of paresthesia of the chin and lower lip. Panoramic radiography showed an ill-defined radiolucency in the left mandibular molar area and the residue of the first molar root. Microscopic examination demonstrated features of mucin-producing adenocarcinoma and was not similar to common neoplasms of the jaw. The whole-body scan revealed multiple osseous uptakes. CDX2 was diffusely positive. However, in the end, the origin of the primary tumor was not determined. Considering the aforementioned data, the diagnosis of metastatic adenocarcinoma with unknown primary origin was made. CUP of the oral cavity is an extremely rare event. The possibility of metastasis should be raised in a patient who complains of paresthesia. Awareness of the clinical and histopathologic features of these malignancies is crucial for clinicians and pathologists to have a proper diagnosis

Extrafollicular Cystic Adenomatoid Odontogenic Tumor of the Maxilla: a Rare Challenging Case Report with Review of the Literature

Adenomatoid odontogenic tumor is a non-aggressive slow growing epithelial odontogenic tumor with varied clinical and microscopic features. This neoplasm rarely appears as a completely cystic lesion histopathologically; therefore, oral pathologists should be aware of the various histopathologic types of this lesion. The main objective of this case report is to present a rare challenging case of maxillary extrafollicular cystic adenomatoid odontogenic tumor affecting a 28-year-old male

Tooth Brushing in Children

Toothbrush is a well-known tool in oral care. Effective tooth brushing can help in the management of dental caries and periodontal disease. Familiarity of children with this device is important. Dentists and their assistant need adequate information about children's oral hygiene to educate them and their parents. The aim of this review was to pinpoint the main issues of brushing teeth in children such as toothbrush design, methods of tooth brushing, and possible hazards of tooth brushing. In conclusion, tooth brushing twice daily under parent's supervision is recommended. Parents can help children and keep them safe from possible hazardous events

Epithelial Salivary Gland Tumors in Ahvaz, Southwest of Iran

Background and aims. Salivary gland tumors are rare and specific lesions. There are differences in the incidence and frequency of salivary tumors in both minor and major salivary glands in different countries. This study was carried out to determine the prevalence of major and minor salivary gland tumors in Ahvaz in the south of Iran. Materials and methods. All the cases, recorded in Imam Khomeyni Hospital and Shafa Hospital, Ahvaz, Iran from 1997 to 2008 were assessed. Age, gender, anatomical location, and histology of all the specimens were evaluated. Results. Of 112 cases, 84 cases were benign and 28 cases were malignant. Female predominance was observed in these cases. Most lesions appeared in the third to fifth decades of life (60.71%). The incidence of malignant salivary gland tumors increased with age and male predominance was found in malignant tumors. The majority of the tumors occurred in parotid gland. Pleomorphic adenoma was the most common histological type (65.17%). Mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common malignant tumors. Conclusion. It was shown that the peak incidence age of all salivary gland tumors was the third to fifth decades, and malignant tumors mostly occurred in the sixth to eighth decades. Female predominance for all the tumors and slight male predominance in malignant tumors were observed. Pleomorphic adenoma was the most common benign tumor. The most common malignant tumors were mucoepidermoid carcinoma and adenoid cystic carcinoma