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9 pages, 2609 KiB  
Interesting Images
The Occurrence of Mandible Brown Tumor Mimicking Central Giant Cell Granuloma in a Case Suspicious of Primary Hyperparathyroidism—Troublesome Diagnostic Dilemmas
by Kamil Nelke, Klaudiusz Łuczak, Maciej Janeczek, Marcelina Plichta, Agata Małyszek, Małgorzata Tarnowska, Piotr Kuropka and Maciej Dobrzyński
Diagnostics 2025, 15(16), 2038; https://doi.org/10.3390/diagnostics15162038 - 14 Aug 2025
Viewed by 199
Abstract
The jaw bones can manifest various cysts and tumors of different origins and etiologies. Any bone lesions lacking any potential odontogenic origin might require more accurate diagnostics, adequate investigation, and careful patient anamnesis. In cases of sharply demarcated radiolucency or mixed radiolucent–radiopaque radiological [...] Read more.
The jaw bones can manifest various cysts and tumors of different origins and etiologies. Any bone lesions lacking any potential odontogenic origin might require more accurate diagnostics, adequate investigation, and careful patient anamnesis. In cases of sharply demarcated radiolucency or mixed radiolucent–radiopaque radiological appearance lesions, they can sometimes extend between the displaced tooth roots or cause their resorption. The scope of cortical bone in radiographic studies might have a different status, and lesions can spread outside of the bone. If no odontogenic feature is present, an additional blood examination for bone markers and calcium–phosphate markers is useful to establish any endocrine-related pathologies. In the primary hyperparathyroidism (PHP), bone blood markers and bone scintigraphy are very useful to establish the possible occurrence of brown tumor. On the other hand, in central giant cell granuloma (CGCG), only a direct tumor lesion biopsy might confirm the diagnosis, where in microscopic evaluation, mostly fibroblasts and secondary cells have multinucleated giant cells along with some accessory cells like macrophages, dendrocytes, and other endothelial cells. Because both lesions can have similar clinical and radiological appearances and unclear borders, with different shapes, sizes, and symptoms, it is quite important to compare both clinical and radiological patient characteristics. The authors aim to present how radiological studies alone can easily lead to lesion misdiagnosis. They also aim to emphasize how local treatment methods without advanced microsurgical reconstruction can, in some cases, improve patient outcomes. Full article
(This article belongs to the Collection Interesting Images)
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7 pages, 10289 KiB  
Case Report
Brown Tumor in Jaw Associated with Hyperparathyroidism: A Case Report
by Verónica Montserrat Silva-Gutiérrez, Judith Berenice Macías-Jiménez, Adriana Molotla-Fragoso, Claudia Patricia Mejía-Velázquez, Gabriel Levi Estévez-González and Luis Fernando Jacinto-Alemán
Oral 2025, 5(3), 59; https://doi.org/10.3390/oral5030059 - 14 Aug 2025
Viewed by 269
Abstract
Background/Objectives: Brown tumors are bone manifestations of hyperparathyroidism, and they are characterized by histologic similarities with Central Giant Cell Granuloma (CGCG). Their diagnosis requires clinical, microscopic, macroscopic, and serologic correlation, as there is usually an elevation in parathormone levels due to the [...] Read more.
Background/Objectives: Brown tumors are bone manifestations of hyperparathyroidism, and they are characterized by histologic similarities with Central Giant Cell Granuloma (CGCG). Their diagnosis requires clinical, microscopic, macroscopic, and serologic correlation, as there is usually an elevation in parathormone levels due to the underlying metabolic disorder. Methods: This case describes a patient with a left mandibular lesion and a history of CGCG. Results: Through the joint analysis of clinical, histologic, and serologic findings, the diagnosis of a brown tumor associated with hyperparathyroidism was confirmed. Conclusions: This case highlights the importance of a comprehensive evaluation of oral and systemic features for accurate diagnoses and appropriate patient management. Full article
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12 pages, 3047 KiB  
Case Report
Oral Rehabilitation Following Surgical Treatment of Mandibular Ameloblastoma: Case Report and Comprehensive Literature Review
by Sepideh Goudarzi, Chiara Cinquini, Rossana Izzetti, Marco Nisi, Mattia Priami, Bruno Carlo Brevi, Luca Bruschini, Fulvio Lorenzetti, Simonetta Santarelli and Antonio Barone
Oral 2025, 5(3), 57; https://doi.org/10.3390/oral5030057 - 8 Aug 2025
Viewed by 320
Abstract
Objectives: Ameloblastoma is a locally aggressive odontogenic tumor of the jaws characterized by a high recurrence rate. This work aims to present our clinical experience in managing patient oral rehabilitation following an extensive mandibular ameloblastoma, with a specific focus on mandibular reconstruction [...] Read more.
Objectives: Ameloblastoma is a locally aggressive odontogenic tumor of the jaws characterized by a high recurrence rate. This work aims to present our clinical experience in managing patient oral rehabilitation following an extensive mandibular ameloblastoma, with a specific focus on mandibular reconstruction using a fibula free flap, followed by dental implant placement and prosthetic rehabilitation in a female patient. Additionally, we provide a comprehensive review of the current evidence on surgical management, reconstruction techniques, and long-term outcomes in ameloblastoma treatment. Methods: A 44-year-old female patient presented with a painless swelling in the left mandible. Orthopantomography (OPG) and computed tomography (CT) demonstrated a well-defined radiolucent lesion extending from the canine to the second premolar. An incisional biopsy was performed, and histopathological examination confirmed the diagnosis of mandibular ameloblastoma. The patient underwent segmental resection of the left mandibular body, followed by immediate reconstruction using a vascularized fibular free flap. Eighteen months postoperatively, four dental implants were placed. One implant failed during the osseointegration phase and was removed. Due to residual hard and soft tissue deficiency, prosthetic rehabilitation was achieved with a metal-reinforced resin overdenture, restoring both function and aesthetics. Results: At the three-year follow-up, clinical and radiographic examinations revealed no evidence of tumor recurrence. The patient remained asymptomatic, reporting neither pain nor functional discomfort. Prosthetic rehabilitation with the metal-reinforced resin overdenture was successfully completed, achieving satisfactory masticatory function and aesthetics. Conclusions: The use of the fibula free flap for mandibular reconstruction after ameloblastoma resection provides excellent flexibility, enabling effective bone integration of dental implants. Full article
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28 pages, 1032 KiB  
Systematic Review
Oral and Dental Sequelae After Oncological Treatment in Children: A Systematic Review
by Lidia Torrecillas-Quiles, Inmaculada Gómez-Ríos, Irene Jiménez-García, Ildefonso Serrano-Belmonte, Antonio José Ortiz-Ruiz and Clara Serna-Muñoz
J. Clin. Med. 2025, 14(15), 5479; https://doi.org/10.3390/jcm14155479 - 4 Aug 2025
Viewed by 391
Abstract
Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have [...] Read more.
Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have led to increased survival in this population, resulting in an increased incidence of long-term effects, which diminish the patient’s quality of life. Methods: The search for articles started on 5 November 2024 and ended on 5 December 2024. Following the PRISMA Statement, a total of 1266 articles were obtained, from which 13 were selected for review. All articles were considered to be of high quality. The antineoplastic treatments used in them were chemotherapy, radiotherapy, surgery and immune therapy. Results: Most articles were cohorts and case controls. Only one case report was obtained. The results revealed that the most prevalent sequelae in the pediatric population after antineoplastic treatment were enamel alterations, microdontia, dental caries, periodontal disease, gingivitis, hyposalivation, alteration of the oral microbiome, alteration of mandibular bone density and malocclusion. The lesions are different depending on the therapy used. Conclusions: Oncologic treatments in children with cancer cause multiple oral sequelae such as microdontia, dental caries, enamel alterations, salivary gland alterations, mucositis and root resorption. It cannot be concluded which therapy has the most detrimental effect as each has a different mechanism of action in the oral cavity. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
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7 pages, 540 KiB  
Case Report
Simultaneous Central Nervous System and Cutaneous Relapse in Acute Myeloid Leukemia
by Eros Cerantola, Laura Forlani, Marco Pizzi, Renzo Manara, Mauro Alaibac, Federica Lessi, Angelo Paolo Dei Tos, Chiara Briani and Carmela Gurrieri
Hemato 2025, 6(3), 25; https://doi.org/10.3390/hemato6030025 - 23 Jul 2025
Viewed by 232
Abstract
Introduction: Acute Myeloid Leukemia (AML) is a hematologic malignancy characterized by the clonal expansion of myeloid progenitors. While it primarily affects the bone marrow, extramedullary relapse occurs in 3–5% of cases, and it is linked to poor prognosis. Central nervous system (CNS) involvement [...] Read more.
Introduction: Acute Myeloid Leukemia (AML) is a hematologic malignancy characterized by the clonal expansion of myeloid progenitors. While it primarily affects the bone marrow, extramedullary relapse occurs in 3–5% of cases, and it is linked to poor prognosis. Central nervous system (CNS) involvement presents diagnostic challenges due to nonspecific symptoms. CNS manifestations include leptomeningeal dissemination, nerve infiltration, parenchymal lesions, and myeloid sarcoma, occurring at any disease stage and frequently asymptomatic. Methods: A 62-year-old man with a recent history of AML in remission presented with diplopia and aching paresthesias in the left periorbital region spreading to the left frontal area. The diagnostic workup included neurological and hematological evaluation, lumbar puncture, brain CT, brain magnetic resonance imaging (MRI) with contrast, and dermatological evaluation with skin biopsy due to the appearance of nodular skin lesions on the abdomen and thorax. Results: Neurological evaluation showed hypoesthesia in the left mandibular region, consistent with left trigeminal nerve involvement, extending to the periorbital and frontal areas, and impaired adduction of the left eye with divergent strabismus in the primary position due to left oculomotor nerve palsy. Brain MRI showed an equivocal thickening of the left oculomotor nerve without enhancement. Cerebrospinal fluid (CSF) analysis initially showed elevated protein (47 mg/dL) with negative cytology; a repeat lumbar puncture one week later detected leukemic cells. Skin biopsy revealed cutaneous AML localization. A diagnosis of AML relapse with CNS and cutaneous localization was made. Salvage therapy with FLAG-IDA-VEN (fludarabine, cytarabine, idarubicin, venetoclax) and intrathecal methotrexate, cytarabine, and dexamethasone was started. Subsequent lumbar punctures were negative for leukemic cells. Due to high-risk status and extramedullary disease, the patient underwent allogeneic hematopoietic stem cell transplantation. Post-transplant aplasia was complicated by septic shock; the patient succumbed to an invasive fungal infection. Conclusions: This case illustrates the diagnostic complexity and poor prognosis of extramedullary AML relapse involving the CNS. Early recognition of neurological signs, including cranial nerve dysfunction, is crucial for timely diagnosis and management. Although initial investigations were negative, further analyses—including repeated CSF examinations and skin biopsy—led to the identification of leukemic involvement. Although neuroleukemiosis cannot be confirmed without nerve biopsy, the combination of clinical presentation, neuroimaging, and CSF data strongly supports the diagnosis of extramedullary relapse of AML. Multidisciplinary evaluation remains essential for detecting extramedullary relapse. Despite treatment achieving CSF clearance, the prognosis remains unfavorable, underscoring the need for vigilant clinical suspicion in hematologic patients presenting with neurological symptoms. Full article
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10 pages, 2239 KiB  
Case Report
Amelanotic Melanocytic Nevus of the Oral Cavity: A Case Report and Literature Review
by Rossana Izzetti, Filippo Minuti, Angela Pucci, Chiara Cinquini, Antonio Barone and Marco Nisi
Diagnostics 2025, 15(12), 1554; https://doi.org/10.3390/diagnostics15121554 - 18 Jun 2025
Viewed by 730
Abstract
Amelanotic melanocytic nevi of the oral cavity are uncommon lesions that often present a diagnostic challenge for clinicians, primarily due to their nonspecific clinical appearance and the broad spectrum of possible differential diagnoses. These lesions can mimic a variety of benign and malignant [...] Read more.
Amelanotic melanocytic nevi of the oral cavity are uncommon lesions that often present a diagnostic challenge for clinicians, primarily due to their nonspecific clinical appearance and the broad spectrum of possible differential diagnoses. These lesions can mimic a variety of benign and malignant conditions, requiring precise histopathological confirmation. The primary objective of this article is to present a comprehensive case report—tracing the course from initial presentation through diagnostic workup to final diagnosis—and to provide an overview of the current literature on oral amelanotic melanocytic nevi. We report the case of a 27-year-old female who presented with a small, exophytic mass located in the anterior mandibular gingival region. The lesion was asymptomatic and lacked pigmentation, adding to the diagnostic uncertainty. A range of differential diagnoses was considered, including pyogenic granuloma, peripheral ossifying fibroma, and squamous cell carcinoma. Due to the lesion’s limited size and accessibility, an excisional biopsy was performed under local anesthesia. Histopathological examination revealed an amelanotic melanocytic nevus, a rare variant characterized by the absence of melanin pigment, further complicating the clinical impression. The diagnosis was confirmed through immunohistochemical staining, which demonstrated melanocytic markers consistent with a nevus. The patient was followed up with for six months postoperatively, with no evidence of recurrence or malignant transformation. This case highlights the critical role of biopsy in achieving a definitive diagnosis, especially in lesions with atypical clinical presentations. It also underscores the importance of considering amelanotic melanocytic nevi in the differential diagnosis of nonpigmented oral lesions, as well as maintaining vigilance regarding the rare possibility of amelanotic melanoma. Full article
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14 pages, 5444 KiB  
Case Report
Radiographic and Histopathological Characteristics of Chronic Nonbacterial Osteomyelitis of the Mandible in Pediatric Patients: Case Series
by Mohammed Barayan, Nagla’a Abdel Wahed, Narmin Helal, Hisham Abbas Komo, Durer Iskanderani, Raghd Alansari, Nada A. Alhindi, Azza F. Alhelo, Hanadi Khalifa and Hanadi Sabban
Diagnostics 2025, 15(12), 1549; https://doi.org/10.3390/diagnostics15121549 - 18 Jun 2025
Viewed by 506
Abstract
Background and Clinical Significance: Chronic nonbacterial osteomyelitis (CNO) of the jaw is a rare autoinflammatory bone disorder that primarily affects children and adolescents. Diagnosing CNO of the mandible can be challenging due to its rarity, and the clinical and radiographic findings overlap with [...] Read more.
Background and Clinical Significance: Chronic nonbacterial osteomyelitis (CNO) of the jaw is a rare autoinflammatory bone disorder that primarily affects children and adolescents. Diagnosing CNO of the mandible can be challenging due to its rarity, and the clinical and radiographic findings overlap with those of other bone disorders. Case Presentation: This case series retrospectively presents four female pediatric patients (9–12 years old) diagnosed with mandibular CNO. The patients were treated at King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia, between 2018 and 2024. Clinical features and radiographic and histopathological findings were evaluated. All cases had mandibular swelling and pain. Radiographic features consistently revealed mixed sclerotic and radiolucent lesions with bone expansion and periosteal reactions. Histopathological findings revealed viable bone interspersed with varying degrees of fibrous tissue. No evidence of bacterial colonies or inflammation was observed. This case series highlights the radiographic and histopathological features of CNO in the mandible of pediatric patients. The mixed radiographic features and variability of histopathological findings combined with the refractory nature of the lesions contribute to diagnostic complexity. Diagnostic challenges include differentiating CNO from other inflammatory and fibro-osseous conditions. The presence of recurrent episodes of pain, the formation of subperiosteal bone, periostitis, lysis of the cortical layer, expansion of the mandibular canal, and sterile bone biopsies with nonspecific inflammatory changes were related mainly to CNO. Conclusions: These findings underscore the need for increased awareness and a multidisciplinary approach for accurate diagnosis and management of CNO. Conservative management, particularly in dental cases, avoids prolonged unnecessary use of antibiotics, and the prescription of nonsteroidal anti-inflammatory drugs should be followed. Full article
(This article belongs to the Special Issue Computed Tomography Imaging in Medical Diagnosis, 2nd Edition)
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10 pages, 211 KiB  
Article
Does the Location of Oral Lesions in Oral Lichen Planus Allow Predicting the Outcome of Its Histopathological Examination?
by Katarzyna Osipowicz, Emilia Milczarek, Renata Gorska, Cezary Kowalewski, Janusz Pach, Piotr Regulski and Katarzyna Wozniak
J. Clin. Med. 2025, 14(12), 4076; https://doi.org/10.3390/jcm14124076 - 9 Jun 2025
Viewed by 471
Abstract
Objective: Numerous reports describe the typical localization of lesions in the oral cavity in various conditions, manifesting as oral lesions. We aimed to evaluate the correlation between these lesions and the results of histopathological examinations (HP). Methods: We examined 66 consecutive patients [...] Read more.
Objective: Numerous reports describe the typical localization of lesions in the oral cavity in various conditions, manifesting as oral lesions. We aimed to evaluate the correlation between these lesions and the results of histopathological examinations (HP). Methods: We examined 66 consecutive patients with oral lesions consistent with the clinical presentation of oral lichen planus (OLP). Standard HP evaluation was performed using light microscopy and, subsequently, the association between the precise location of the lesion and the histopathological diagnosis was assessed. Results: Erosions on the mandibular gingiva (p = 0.0086), white patches on the right buccal mucosa (p = 0.03197), white patches on the ventral surface of the tongue (p = 0.0397), white patches on the maxillary gingiva (p = 0.0228), white patches on the mandibular gingiva (p = 0.0062), white patches on the upper lip (p = 0.0226), and bilateral white patches on the buccal mucosa (p = 0.0104) were significantly more prevalent in patients with positive histopathological findings. White patches on the buccal mucosa emerged as the strongest predictor of histopathological diagnosis of OLP, with a sensitivity of 91.3% and a negative predictive value of 85.7%. Conclusions: The location of oral lesions may indicate OLP with high sensitivity and a negative predictive value, which may facilitate further diagnostic management; however, it is not sufficient to establish a definitive diagnosis. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
15 pages, 10258 KiB  
Case Report
Comprehensive Management of Odontogenic Myxofibroma in the Mandible: A Four-Year Follow-Up Case Report with a Review of Differential Diagnosis and Treatment Approaches
by Joanna Wójcik, Liliia Yefanova, Kacper Nijakowski, Katarzyna Bednarek-Rajewska, Krzysztof Osmola and Maciej Okła
Oral 2025, 5(2), 39; https://doi.org/10.3390/oral5020039 - 3 Jun 2025
Viewed by 631
Abstract
Odontogenic myxofibroma (OMF) is a rare, benign, and slow-growing tumour arising from odontogenic ectomesenchyme. Despite its low prevalence, accounting for approximately 0.5% to 17.7% of all odontogenic tumours worldwide and 3.1% in specific regional studies, it poses significant challenges due to its potential [...] Read more.
Odontogenic myxofibroma (OMF) is a rare, benign, and slow-growing tumour arising from odontogenic ectomesenchyme. Despite its low prevalence, accounting for approximately 0.5% to 17.7% of all odontogenic tumours worldwide and 3.1% in specific regional studies, it poses significant challenges due to its potential for local recurrence if inadequately excised. This case report presents the clinical course, surgical management, and follow-up of a 35-year-old female patient diagnosed with OMF in the mandibular body region. The patient presented with an osteolytic lesion between the first and second mandibular molars, as confirmed through CT imaging, with dimensions of 31 × 22 × 24 mm. Histopathological examination following excisional biopsy under general anaesthesia confirmed the diagnosis of OMF. The surgical procedure involved mandibular segment resection and reconstruction using an iliac crest bone graft stabilised with plates. Subsequent implantation procedures in 2021 restored dental function, and a four-year follow-up demonstrated excellent outcomes, with no signs of recurrence, periimplantitis, or bone graft compromise. This case highlights the importance of comprehensive imaging, histopathological confirmation, and long-term monitoring in managing odontogenic myxofibroma. Early detection and appropriate surgical intervention significantly improve patient outcomes and quality of life. Full article
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7 pages, 2458 KiB  
Interesting Images
An Atypical Growth and Maturation Stage of Mandibular Ossifying Fibroma Occurrence Resembling a Different Fibro-Osseous Lesion—Correlation Between Radiological and Histopathological Data
by Kamil Nelke, Klaudiusz Łuczak, Marcelina Plichta, Maciej Janeczek, Agata Małyszek, Piotr Kuropka and Maciej Dobrzyński
Diagnostics 2025, 15(11), 1367; https://doi.org/10.3390/diagnostics15111367 - 29 May 2025
Viewed by 547
Abstract
The occurrence of osseous, fibrous, and fibro-osseous lesions in the jaw bones might pose challenges for accurate diagnosis and the selection of the best therapeutic approach. Certain radiolucent, radiopaque, or mixed-origin lesions can look very similar to other bone lesions, because of the [...] Read more.
The occurrence of osseous, fibrous, and fibro-osseous lesions in the jaw bones might pose challenges for accurate diagnosis and the selection of the best therapeutic approach. Certain radiolucent, radiopaque, or mixed-origin lesions can look very similar to other bone lesions, because of the stages of their growth, calcification, maturation, and possible local factors affecting the lesion. Ossifying fibroma (OsF, OF) is a type of fibro-osseous lesion, whose radiological characteristics might sometimes be uncertain. It may appear on classic radiographs and cone beam computed tomography as a radiolucent/radiopaque lesion with calcification bodies or a shape with a cloud-like appearance. The appearance is mostly related to the lesion’s maturation level, calcification stage, and number of fibrous elements. Diagnosis might be challenging. Its histopathological evaluation reveals a combination of mineralized and fibrous connective tissues in the mass. From a radiological point of view, because of the tumor’s various stages of bone remodeling, formation, and resorption, diagnosis might be troublesome. Different diagnoses should include cemento-osseous dysplasia, fibrous dysplasia, or cementoblastoma. A biopsy could provide an accurate histopathological examination, improving diagnosis and influencing later surgical approaches. Regardless of the final specimen evaluation, surgery is the treatment of choice. The authors would like to present the correlation between radiological and histopathological data in tumor treatment outcomes. Full article
(This article belongs to the Collection Interesting Images)
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12 pages, 6585 KiB  
Article
Microtensile Bond Strength of Composite Restorations: Direct vs. Semi-Direct Technique Using the Same Adhesive System
by Paulo J. Palma, Maria A. Neto, Ana Messias and Ana M. Amaro
J. Compos. Sci. 2025, 9(5), 203; https://doi.org/10.3390/jcs9050203 - 24 Apr 2025
Cited by 1 | Viewed by 760
Abstract
The main purpose was to evaluate the in vitro adhesion strength of direct and semi-direct composite resin restorations in dentin, when the same adhesive system is applied, using microtensile testing (μTBS) and to observe the most recurrent types of failure in the different [...] Read more.
The main purpose was to evaluate the in vitro adhesion strength of direct and semi-direct composite resin restorations in dentin, when the same adhesive system is applied, using microtensile testing (μTBS) and to observe the most recurrent types of failure in the different groups. For this study, 16 intact human mandibular molars without microscopic evidence of lesions were randomly divided into two test groups, according to the restoration strategy: direct restoration (DR) and semi-direct restoration (SR). For both restorative strategies, the same adhesive system (Clearfil SE Bond 2, Kuraray, Tokyo, Japan) was applied to the dentin surface using a two-step self-etching approach with no prior conditioning of the dentin, and the same composite resin (Ceram. x Sepctra ST HV, Dentsply Sirona, Charlotte, NC, USA) was used as a restorative material. The indirect restoration was cemented using resin cement (Variolink Esthetic LC, Ivoclar Vivadent, Schaan, Liechtenstein) within the interior side of the restoration. Each specimen was sliced into sections measuring approximately 1 mm2. The rods were then subjected to a microtensile bond strength test and the statistical analysis on the differences in μTBS between the groups were determined with the Mann–Whitney test. The surfaces were examined to determine the failure mode. The Chi-Square test was used to determine the association between the type of restoration and the failure mode. The DR group presented with a mean μTBS of 38.15 ± 10.75 MPa and a predominance of cohesive failures in the composite resin (69.5%). The SR group showed a mean μTBS of 25.45 ± 10.19 MPa and a predominance of adhesive failures (92.3%). There was not only a statistically significant difference in the adhesive strength of the DR and SR groups (p < 0.001), but also a statistically significant association between the type of restorative strategy and failure mode (p < 0.001). Even though Clearfil SE Bond 2 provided acceptable adhesion to the dentin, using the same two-step self-etch adhesive system, lower adhesive strength and more adhesive failures are expected in semi-direct restorations when compared to direct restorations. Full article
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9 pages, 2986 KiB  
Case Report
Exposed Necrotic Bone in a Head and Neck Cancer Patient: Report of a Diagnostic Challenge
by Fabio Dell’Olio, Rosaria Arianna Siciliani, Marta Forte, Saverio Capodiferro, Gianfranco Favia and Luisa Limongelli
Diagnostics 2025, 15(8), 952; https://doi.org/10.3390/diagnostics15080952 - 9 Apr 2025
Cited by 1 | Viewed by 695
Abstract
Background and Clinical Significance: The current study aims to show the diagnostic challenge of mandibular exposed necrotic bone in a patient with locally aggressive cutaneous squamous cell carcinoma of the lower lip and carrying risk factors for osteoradionecrosis and medication-related osteonecrosis of the [...] Read more.
Background and Clinical Significance: The current study aims to show the diagnostic challenge of mandibular exposed necrotic bone in a patient with locally aggressive cutaneous squamous cell carcinoma of the lower lip and carrying risk factors for osteoradionecrosis and medication-related osteonecrosis of the jaws. Case Presentation: In March 2023, an 80-year-old ex-farmer male patient complaining of feeding difficulty showed a 3 cm area of exposed bone in the left region of the mandible. In July 2020, the patient underwent an incisional biopsy of a lower labial cutaneous keratinizing squamous cell carcinoma, which developed within actinic cheilitis. The cancer was unresectable due to the extent of the local invasion; thus, the patient underwent radiotherapy. In February 2022, the cancer reached the left mandibular canal by completely infiltrating the homolateral canal of the mental nerve. Therefore, the oncologist prescribed cemiplimab and denosumab as palliative immunotherapy. The differential diagnosis included osteoradionecrosis, stage-III medication-related osteonecrosis of the jaws, and intraoral localization of the cutaneous squamous cell carcinoma. The oral surgeon performed a sequestrectomy under local anesthesia and antibiotic prophylaxis; a histological examination confirmed the hypothesis of medication-related osteonecrosis. The patient currently undergoes follow-up visits monthly; the combination of photobiomodulation therapy and cycles of antibiotics keeps the necrotic lesion steady, and the oncological therapy prevents the growth of the cutaneous squamous cell cancer. Conclusions: The current case supports the need for histological examination to resolve the diagnostic challenge of mandibular exposed necrotic bone and to differentiate among osteoradionecrosis, stage-III medication-related osteonecrosis of the jaws, and intraoral localization of cutaneous squamous cell carcinoma. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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23 pages, 2921 KiB  
Article
Oral Clinical and Radiological Signs of Excessive Occlusal Forces in Bruxism
by Adrian Marcel Popescu, Mihaela Ionescu, Sanda Mihaela Popescu, Alin Gabriel Ionescu, Diana Elena Vlăduțu, Monica Mihaela Iacov-Crăițoiu, Alexandru Ștefârță, Luana Corina Lascu and Veronica Mercuț
Diagnostics 2025, 15(6), 702; https://doi.org/10.3390/diagnostics15060702 - 12 Mar 2025
Viewed by 2164
Abstract
Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures [...] Read more.
Background/Objectives: Excessive occlusal forces manifest in bruxism and have consequences on teeth and jaws. The aim of this study was to determine the association of bruxism with clinical and radiological signs of excessive occlusal forces, such as tooth wear, fatigue dental fissures and fractures, abfraction, masseter muscle hypertrophy, and bone apposition at the mandibular angle. Methods: This cross-sectional clinical study included 181 patients presented for treatment in a general dentistry clinic. For each patient, data were extracted from the dental chart, as follows: demographic data (sex, age, and smoking), clinical data (number of teeth present, Eichner edentulous score, TWI wear score, number of fractured teeth, number of teeth with abfraction, presence of masseter hypertrophy, presence of hypersensitivity), and radiological data (bone apposition at the mandibular angle). The patients were divided into two groups according to the presence or absence of bruxism. A binomial logistic regression model was run to determine the association between bruxism and clinical and radiological signs of excessive occlusal forces. The data were statistically processed in SPSS. Results: In total, 99 women and 82 men with mean age 44.87 ± 12.67 were included in the study. Compared to the group without bruxism, the group of patients with bruxism (39.78%) showed statistically significant higher tooth wear index (TWI) (p < 0.0005), a higher number of fractured teeth (p = 0.037), a higher number of teeth with abfraction lesions (p = 0.001), and a significantly higher bone apposition score (p < 0.0005). The binomial logistic regression model showed a high prediction bruxism score for masseter muscle hypertrophy (15 times, p < 0.0005), for tooth wear index (almost 7 times, p = 0.010), and for bone apposition score (almost 3 times, p = 0.044). Conclusions: Patients with bruxism showed masseter muscle hypertrophy, higher attrition-type tooth wear index, and more teeth with fatigue fractures and abfractions than those without bruxism. Bruxism clinical signs were positively correlated with a higher bone apposition score. Full article
(This article belongs to the Section Medical Imaging and Theranostics)
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20 pages, 5171 KiB  
Case Report
Sporadic Burkitt Lymphoma First Presenting as Painful Gingival Swellings and Tooth Hypermobility: A Life-Saving Referral
by Erofili Papadopoulou, Maria Kouri, Dimitrios Velonis, Anastasia Andreou, Maria Georgaki, Spyridon Damaskos, Evangelia Piperi, Konstantina Delli, Ioannis K. Karoussis, Antonia Vlachou, Georgia Avgerinou, Antonis Kattamis and Nikolaos G. Nikitakis
Dent. J. 2025, 13(1), 6; https://doi.org/10.3390/dj13010006 - 25 Dec 2024
Viewed by 1515
Abstract
Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma (NHL), subdivided into endemic, sporadic, and immunodeficiency-associated forms. While jaw lesions are common in endemic BL, they are infrequent in sporadic cases, only rarely constituting the first manifestation of the disease. The aim of [...] Read more.
Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin lymphoma (NHL), subdivided into endemic, sporadic, and immunodeficiency-associated forms. While jaw lesions are common in endemic BL, they are infrequent in sporadic cases, only rarely constituting the first manifestation of the disease. The aim of this study is to present a rare pediatric case of sporadic BL first manifesting as gingival swellings and tooth hypermobility and provide a review of all the published sporadic BL case reports as the first sign of disease. Case report: An 11-year-old Caucasian female was referred for the evaluation of hypermobility of posterior lower teeth, associated with painful gingival swellings of 20 days duration. Clinical examination revealed right facial asymmetry and bilateral prominent swellings of the posterior lower gingiva. A panoramic radiograph revealed ill-defined radiolucent lesions in the posterior mandible bilaterally. On computed tomography, soft-tissue masses were identified along the mandibular ramus extending into the maxillary sinus bilaterally. The histopathologic and immunohistochemical analyses of the lesions led to a diagnosis of Burkitt lymphoma (BL). The patient underwent a full staging work-up, revealing bone marrow involvement and widespread disease. A multi-chemotherapy regimen was initiated with the regression of oral lesions and symptoms within a few weeks and complete disease remission after nine chemotherapy cycles. The patient remains free of disease 11 years later. Conclusions: This case underscores the critical importance of the timely diagnosis and life-saving referral of rapidly growing jaw lesions, which may represent the first sign of an underlying lymphoreticular malignancy with aggressive course, such as BL. Full article
(This article belongs to the Topic Oral Health Management and Disease Treatment)
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Article
The Prevalence and Diagnostic Patterns of Oral and Maxillofacial Lesions: A Seven-Year, Retrospective, Single-Center Cone Beam Computed Tomography and Histopathology Study in Saudi Arabia
by Shadi Alzahrani, Tagreed Wazzan, Abdulaziz Almaghrabi, Abdulaziz Alkhudran, Hamzah Aljereb, Shadia Elsayed and Albraa B. Alolayan
J. Clin. Med. 2024, 13(24), 7774; https://doi.org/10.3390/jcm13247774 - 19 Dec 2024
Cited by 1 | Viewed by 1158
Abstract
Objective: To determine the prevalence of oral and maxillofacial lesions among patients at King Abdulaziz University from January 2016 to December 2022. Methods: This cross-sectional observational study included patients diagnosed with oral and maxillofacial intra-bony lesions based on radiological findings and confirmed [...] Read more.
Objective: To determine the prevalence of oral and maxillofacial lesions among patients at King Abdulaziz University from January 2016 to December 2022. Methods: This cross-sectional observational study included patients diagnosed with oral and maxillofacial intra-bony lesions based on radiological findings and confirmed by histopathological examination. The lesions were classified according to the fourth edition of the World Health Organization Classification of Head and Neck Tumors. Results: This study included 237 patients with a mean age of 31.53 ± 14.97 years, of which 45.1% were female. Most patients (46.7%) had mandibular lesions, followed by maxillary lesions (35.9%). Only 2.95% of the tumors were malignant. Odontogenic cysts were the most prevalent (65.40%), with radicular cysts and keratocytes being the most common types. The most prevalent tumor types were odontoma and ameloblastoma. The most malignant lesion was multiple myeloma. Conclusions: Our findings reveal that mandibular cystic lesions predominated, and emphasize the low incidence of malignancy in the study population. They provide valuable insights into the oral and maxillofacial lesion landscape at a high-volume tertiary care center. Full article
(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Current Updates and Perspectives)
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