This case describes surgical correction of unilateral coronoid hyperplasia in a 13-year-old boy due to trauma. Treatment included coronoidectomy by intraoral approach after the diagnosis was confirmed. Computed tomography scan and occipitomental view radiograph were utilized for investigation. The resected coronoid process was sent for histopathological study. The histopathological examination revealed decalcified sections showing osteochondroid hyperplasia at the expanded end. On clinical and radiographic review at 2 years postoperation, the patient was well, completely symptom free and had improved mouth opening. This case report demonstrates the management of sports injury related unilateral coronoid hyperplasia. Emphasis was also placed on postoperational rehabilitation to prevent any relapse.
Minor oral surgery in warfarinized patients can be performed without stopping or altering the dose of the drug. Thirty patients underwent various types of oral surgical procedures without interruption of their anticoagulant therapy and their therapeutic international normalized ratio maintained. Local measures such as pressure, packing the sockets with oxidized regenerated cellulose, and suturing were applied. In some patients, tranexamic acid mouthwashes were prescribed to further enhance haemostasis. Four patients had minimal postoperative bleeding in the form of bloodstained saliva, which lasted for 24 hours. This study highlights the importance of local measures in controlling postoperative bleeding in warfarinized patients undergoing minor oral surgical procedures.
Mandibular swellings may occur as a result of many benign lesions of odontogenic or non-odontogenic origin. Ameloblastomas are benign tumours of odontogenic origin, whose importance lies in its potential to grow into enormous size with resulting bone deformity, it is a slow-growing, persistent, and locally aggressive neoplasm. The unicystic ameloblastoma (UA) represents an ameloblastoma variant, presenting as a cyst clinically and radiographically, but showing typical ameloblastomatous epithelium lining histologically. It commonly occurs in second and third decades of life and is rare in children under 12 years of age, and better response to conservative treatment. It shares many clinical and radiographic features with odontogenic cysts/tumours and/or periapical disease of endodontic origin. Reported here is an unusual case of unicystic ameloblastoma involving the crown of an unerupted mandibular first premolar in a 9-year boy in an uncommon location, which was misdiagnosed as periapical lesion of inflammatory origin clinically, and as a dentigerous cyst radiographically. This highlights the importance to routinely submit the removed surgical specimen for histopathological examination.
The retromolar foramen (RMF) and retromolar canal (RMC) are the anatomical structures of the mandible located in retromolar fossa behind the third molar tooth. This foramen and canal contain neurovascular structures which provide accessory/additional innervation to the mandibular molars and the buccal area. These neurovascular contents of the canal gain more importance in medical and dental practice, because these elements are vulnerable to damage during placement of osteointegrated implants, endodontic treatment and sagittal split osteotomy surgeries and a detailed knowledge of this anatomical variation would be vital in understanding failed inferior alveolar nerve blockage, spread of infection and also metastasis. Although few studies have been conducted in the past showing the incidence and types in different population groups, a lacunae in comprehensive review of this structure is lacking. Though this variation posed challenging situations for the practicing surgeons, it has been quite neglected and the incidence of it is not well presented in all the textbooks. Hence, we made an attempt to provide a consolidated review regarding variations and clinical applications of the RMF and RMC.