Radiolucent Appearance Research Articles

Central odontogenic fibroma: retrospective study of six cases with variable histopathologic features using 2022 WHO classification

BackgroundCentral odontogenic fibroma (COF) is a rare benign odontogenic tumor with a wide range of histopathologic features. We evaluated COF diagnosed in our institute with 16 years’ experience using 2022 WHO classification.MethodsOur archives were reviewed and cases diagnosed as COF were selected. Clinical, radiographic and microscopic features were tabulated and analyzed.ResultsOf 13,736 specimens, six cases (0.04%) of COF were discovered. Patients ranged in age from 14 to 44 years. There were two males and four females. Maxilla and mandible were affected equally. Five cases showed radiolucent appearance (4 unilocular, 1 multilocular) and one case showed a mixed radiolucent-radiopaque pattern. Histopathologically, three cases were conventional type (2 epithelium-rich, 1 epithelium-poor). Two cases were the hybrid COF with central giant cell granuloma (CGCG) and one of which was also associated with secondary aneurysmal bone cyst (ABC). The last case with a mixed radiolucent-radiopaque pattern was the ossifying subtype.ConclusionOur results demonstrated that COF is a rare odontogenic tumor and exhibits diverse radiographic and microscopic appearances. The triphasic tumor consisting of the COF, CGCG and ABC, is reported here for the first time, while the ossifying subtype is considered the tenth case reported in the English-language literature. Oral and maxillofacial pathologists and other healthcare personnel must be aware of this rare odontogenic tumor and its variants to achieve the definite diagnosis.Clinical trial numberNot applicable.

Influence of proximal femoral morphology on osteointegration of the AMIS uncemented femoral stem in modern hip arthroplasty

BackgroundIndications for total hip arthroplasty (THA) have evolved over recent decades, with a growing trend toward operating on younger and more active patients. With this shift in patient demographics, there has been a change in femoral stem designs and proximal femoral morphology encountered. This study aimed to evaluate the potential correlation between femoral stem osteointegration and proximal femoral morphology using the Dorr and Noble classifications.Materials and methodsWe conducted a retrospective review of 122 uncemented femoral stems (AMIstem Medacta, triple tapered). The demographic data analyzed included sex, age, stem size, and surgical indications. Preoperative radiographs were reviewed to determine the Dorr classification as well as the canal-to-calcar isthmus ratio, cortical index, and canal flare index. Postoperative radiographs were carefully reviewed to identify the presence of potential postoperative radiolucencies. Inter- and intra-observer agreements for these parameters were also analyzed.ResultsSignificant radiolucencies (> 2 mm) were found in 19.5% of the patients. Of all the variables analyzed, the cortical index was the only parameter significantly associated with the appearance of clinically significant radiolucency, with a threshold value of 0.62.ConclusionsThe appearance of radiolucencies is multi-factorial. Nevertheless, in this study, a high cortical index (> 0.62), representing the champagne flute morphology, was found to be associated with the development of significant radiolucencies.

Radiographic evaluation of the healing process of alveolar abscess through regulation of VEGF and angiogenesis

Objectives: This review article aims to explain how the regulation of vascular endothelial growth factor (VEGF) and angiogenesis on alveolar abscess healing process evaluation using radiograph. Review: The databases used in this review are Google Scholar, PubMed, and Science Direct. A total of 1280 search results appeared based on keywords. The search results were selected by title and abstract according to their relevance to the review topic. A total of 24 literatures were reviewed. The alveolar bone destruction is one of the signs of an inflammatory lesion in the alveolar bone. Bone damage that occurs in cases of the abscess will reduce the absorption of x-rays thereby giving a radiolucent appearance on radiographic examination. A radiographic examination is a supporting examination that can be used to develop the healing process. The processes of angiogenesis and osteogenesis of bone homeostasis will complement each other for the bone healing process, while VEGF is a growth factor that can increase the expression of BMPs and osteoblast differentiation so that the bone healing process can take place properly. Conclusion: VEGF plays a significant role in both bone healing and regulation of vascular development and angiogenesis. However, excessive VEGF can also be harmful to the process of bone repair because it can stimulate the recruitment of osteoclasts. Therefore, VEGF regulation has an important role in apical abscess healing, and radiographic images that are quantitatively analyzed can be used to quantify this healing process.

Bone Regeneration on Chronic Apical Abscess After Root Canal Treatment

Chronic Apical Abscess is explained as an inflammatory reaction to pulp infection and necrosis. It is characterized by intermittent discharge of pus through an intraoral sinus tract and usually associated with little or no discomfort. On radiograph examination showed radiolucency as signs of periapical bone destruction. Root canal treatment can elimination bacteria as source of the infection in root canal system. Purpose: these two case report aims to present the management of chronic apical abscess with bone destruction in periapical area. Case report: (1) A 21-years-old female came to complained of a lack of self-confidence due to her upper-front tooth was broken about 8 years ago. Clinical examination showed no discomfort on percussion test, negative on palpation and vitality test. Periapical radiography showed a radiolucent with clear but indistinct boundaries, oval in shape with a diameter of approximately 4 mm. (2) A 20-years-old male complained that his front teeth were broken and discoloured. This complaint had been felt for a long time about 7 years ago. The patient had felt spontaneous pain in the tooth that was hit during the accident for a week. Currently, the tooth is no longer painful. There is no swelling in the gum area where the tooth has changed colour. Radiological examination showed bone damage with a periapical radiolucent appearance with diffuse oval borders with a diameter of 5-6 mm. The diagnosis of these two cases were pulp necrosis with chronic apical abscess. Root canal treatment were performed to elimination bacteria of source infection. First case was restoration using composite resin crown with fiber post intracanal restoration and the second case was restoration using direct restoration. Conclusion: proper root canal treatment resulting bone regeneration and periapical lesions healing in chronic apical abscess cases.

Cemento-Ossıfyıng Fibroma in the Mandibular Posterior Region: 2 Case Reports

Objective: Cemento-ossifying fibroma (COF) is a mesenchymal, benign odontogenic tumor of the jaws that originates from the mesenchymal blast cells of periodontal ligament and can form osteoid, bone, cement-like tissue, fibrous cellular tissue or a combination of them. In this case report, it is aimed to present clinical, radiological and histopathological examination of two cemento-ossifying fibroma cases. 
 Case Report
 36-year-old systemically healthy female patient was referred to our faculty due to a lesion detected in the right mandibular posterior region. As a result of the clinical and radiological examination, an asymptomatic tumoral structure with a mixed appearance and regular borders was detected. There is no expansion was detected in the right mandibular posterior region. The patient was referred to the Department of Oral and Maxillofacial Surgery for biopsy. According to the biopsy report, it was learned that this tumoral structure was a COF.
 38-year-old systemically healthy female patient was admitted to our faculty due to gingival bleeding. As a result of the clinical and radiological examination, an asymptomatic lesion with a radiolucent appearance and sclerotic borders was detected in the right mandibular posterior region. According to the patient's biopsy report, it was learned that this lesion was a COF.
 Discussion: COF may exhibit different clinical and radiological behaviors based on its stage. Diagnosis and treatment planning of COF should be made with clinical, radiological and histopathological examination. 
 Conclusion: Two COF cases are reported with their detailed clinical and radiological examinations in this paper.

PATHWAY OF INFECTION IN CANINE FOSSA SPACE ABSCESS

ABSTRACTBackground: Most of fascial space infections of head and neck caused by odontogenic infections. The canine space becomes involved primarily as the result of infections from the maxillary canine tooth. The buccal space may become infected from extensions of infection from either the maxillary or mandibular teeth.Purpose: This case report discusses the management of canine fossa space abscess extending to buccal space.Case: A-45-years-old male patient came to the A.W. Sjahranie Hospital with complaints of swelling in his left face since two weeks ago. Physical examination showed swelling in the upper left jaw. CT scan’s view showed a radiolucent appearance of the canine fossa region. Panoramic radiograph pointed upper left canine (23) and first molar (26) as source of infection. Based on clinical and radiographic examinations, the patient was diagnosed with a canine fossa space abscess. Case Management: The treatment was given are intravenous antibiotics, multiple tooth extraction followed by intraoral drainage incision under general anesthesia.Conclusion: Extension of infection of the canine fossa space can lead to the buccal space and maxillary sinus at the same time due to multiple carious tooth. Keywords : Buccal space abscess, Canine fossa space abscess, Maxillary sinus, Odontogenic infection

A prospective study of 93 unicompartmental knee prosthesis emphasises the appearance of radiolucencies under the tibial component

Here, we report the presence of radiolucent lines in a consecutive group of 93 partial knee replacements (UKA). The prospective study was conducted from 2011 to 2019 with a minimum follow-up of two years. Clinical data and radiographs were recorded. Of the 93 UKA, 65 were cemented. The Oxford Knee Score was recorded before and two years after surgery. In 75 cases, the follow-up was conducted at > 2 years. A lateral knee replacement was performed in 12 cases. In one case, a medial UKA with patellofemoral prosthesis was performed. In eight patients (8.6%), a radiolucent line (RLL) underneath the tibia component was observed. In four of these eight patients, RLLs were non-progressive, without clinical implications. In two cemented UKAs, RLLs were progressive and were revised with total knee arthroplasty. Early severe osteopenia of the tibia (zone 1 to 7) in the frontal view was observed in two cementless medial UKA cases. The demineralisation occurred spontaneously five months after surgery. We diagnosed two early deep infections, one of which was treated locally. RLLs were present in 8.6% of the patients. Even in severe cases of osteopenia, spontaneous recovery of RLLs is possible with cementless UKAs.

Crown root fracture imaging on Cone Beam Computed Tomography

Objectives: This case report is aimed to describe the features of CBCT in assessing tooth fracture.
 Case Report: A 50-year-old man came with complaints of discomfort in the right lower jaw area, especially when used for chewing. The results of the percussion test were positive. CBCT examination showed that there was a radiolucent image of the enamel in the middle of the crown root to the 1/3 apical of the mesial and distal roots of tooth 47 which resembled a fracture line. The fracture line also appears to have reached the pulp. In addition, there is a well-defined radiolucent appearance with an irregular shape along the root from the buccal to lingual alveolar crest and accompanied by a decrease in the alveolar crest. The fracture that occurred in this case was from the enamel to the apical and involved the pulp, thus the radiodiagnosis on tooth 47 was a complicated crown root fracture with lateral periodontal cyst.
 Conclusion: CBCT can be used to help identify tooth fractures by obtaining a more accurate and useful value in differentiating conditions associated with fractures. CBCT provides data on the size and length of the fracture line and the size of the lesion.

Bone Augmentation in Extrusive Teeth Repositioned Using Bone Grafts

Extrusive luxation is a traumatic dental injury (TDI) due to the action of forces, especially in the oblique angle. Partial displacement of the tooth is one of its characteristics. Repositioning is the treatment of choice for this type of trauma. The mechanism of bone augmentation and splint in managing the post extrusive luxation teeth reposition was explored and reported. An 18-year-old male with a history of traffic accident which caused extrusive luxation of 11 and 21 with no alveolar bone fracture. The patient was managed by repositioning the teeth and applicating arch-bar on anterior maxillary teeth. After eight weeks of evaluation, periapical radiograph showed the distal bone of 21 had radiolucent appearance followed by Class 1 mobility. The arch-bar was removed, and the periosteal flap was made on the buccal side of 21 and the distal part was curetted then irrigated with 0.9% sodium chloride, then supplemented with bone graft material and pericardium membrane. Lastly, the flap was returned, the tooth was then stabilised using self-curing adhesive resin cement (Super-Bond). The tooth was kept under observation for two months. It was observed that the tooth was asymptomatic and still in function with no radiographic signs of pathosis. These results suggested that tooth reposition might be an alternative to prosthetic or implant dentistry. However, further human research is recommended with long standing follow-up periods and comparative studies to be carried out to identify whether dental implant replacement or reposition is the cost-effective treatment for extruded tooth.

DEMOGRAPHIC AND CLINICAL PROFILE OF DEVELOPMENTAL ODONTOGENIC CYSTS IN A BRAZILIAN POPULATION

Odontogenic cysts (OCs) are the most frequent lesions of gnathic bones and present with unique clinical findings and diverse biological behavior. Objective: To describe the demographic and clinical characteristics of developmental OCs diagnosed in a pathologic anatomy service. Study design: Through retrospective and descriptive analyses, data referring to age, sex, size, location, and radiographic characteristics were obtained from the biopsy request forms in the period 2002-2018. Results: A total of 135 cases of developmental OC were identified, of which 48% (n = 65) were odontogenic keratocyst (OKC), 36% (n = 49) dentigerous cyst (DC), 9% (n = 12) calcifying odontogenic cyst (COC), 3% (n = 4) gingival cyst of adult, and 1.48% (n = 2) glandular odontogenic cyst (GOC). Lateral periodontal cyst (LPC), botryoid odontogenic cyst (BOC), and orthokeratinized odontogenic cyst (OOC), were 1% (n = 1) each. Mean age of the patients was 30.6 years, with no predilection for sex. OKC, COC, and GOC showed the largest sizes, with averages of 2.92 cm, 2.67 cm, and 4.0 cm, respectively. The posterior mandible was affected more often (59%; n = 80). Radiographically, 41.5% exhibited a unilocular radiolucent appearance. Conclusion: DC and OKC were more frequent in this study. Developmental OCs predominated in the posterior mandible and the most aggressive lesions were large in sizes. Odontogenic cysts (OCs) are the most frequent lesions of gnathic bones and present with unique clinical findings and diverse biological behavior. Objective: To describe the demographic and clinical characteristics of developmental OCs diagnosed in a pathologic anatomy service. Study design: Through retrospective and descriptive analyses, data referring to age, sex, size, location, and radiographic characteristics were obtained from the biopsy request forms in the period 2002-2018. Results: A total of 135 cases of developmental OC were identified, of which 48% (n = 65) were odontogenic keratocyst (OKC), 36% (n = 49) dentigerous cyst (DC), 9% (n = 12) calcifying odontogenic cyst (COC), 3% (n = 4) gingival cyst of adult, and 1.48% (n = 2) glandular odontogenic cyst (GOC). Lateral periodontal cyst (LPC), botryoid odontogenic cyst (BOC), and orthokeratinized odontogenic cyst (OOC), were 1% (n = 1) each. Mean age of the patients was 30.6 years, with no predilection for sex. OKC, COC, and GOC showed the largest sizes, with averages of 2.92 cm, 2.67 cm, and 4.0 cm, respectively. The posterior mandible was affected more often (59%; n = 80). Radiographically, 41.5% exhibited a unilocular radiolucent appearance. Conclusion: DC and OKC were more frequent in this study. Developmental OCs predominated in the posterior mandible and the most aggressive lesions were large in sizes.

Bilateral canine space infection secondary to odontogenic origin. A rare case report.

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a radiolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To perform treatment of odontogenic infections, the Oral & Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

Radiographic Appearance of Interocclusal Record Materials for Cone Beam Computed Tomography-Guided Implant Surgeries.

To select an ideal interocclusal record material for cone beam computed tomography (CBCT)-guided implant surgery based on the material's radiodensity on the scan. Twelve commonly used interocclusal record materials were used for this investigation: two were waxes, one was polyether, and nine were polyvinyl-siloxane-type materials. A scan template was fabricated by duplicating existing dentures in Ortho-Jet acrylic resin mixed with 30% barium powder for the teeth and 10% barium powder for the denture base between the teeth and the tissue. An interocclusal record was fabricated with each material, and the same template was used to obtain a CBCT scan with an ICAT machine (Imaging Sciences International) at 0.3 voxel and 14-bit depth settings. Twelve CBCT scans were obtained and analyzed. The radiopacity of the barium teeth was used as a control and was compared with the opacity of the 12 materials using a paired t test. A post hoc analysis of variance (ANOVA) test was used to compare the densities of the various materials with each other. There was a statistically significant difference between the radiopacity of barium teeth (gray value: 1,959.475) and that of Modelling Wax (gray value: 750; P = .0026), Aluwax (gray value: 795.22; P = .0022), Blu-Bite CT (gray value: 1,105; P = .005), Ramitec (gray value: 1,105.3; P = .08), Memosil 2 (gray value: 1,202; P = .01) followed by Reprosil (gray value: 1,407.73; P = .01). Compared with the barium teeth, there was no statistically significant difference between the densities of Futar D (gray value: 1,866.5; P = .51), Jet Bite (gray value: 1,660.04; P = .08), Lab-Putty (gray value: 1,402.14; P = .19), and Memoreg 2 (gray value: 1,754.72; P = .1). The highest radiodensity was seen with Blu-Mousse (gray value: 2,949; P = .007) and Take 1 (gray value: 2,229.85; P = .025), which were also significantly different from the density of the barium teeth but in the opposite direction, making them more opaque. Within the limitations of this in vitro study, the most radiolucent appearance of Modelling Wax, Aluwax, Memosil 2, Blu-Bite CT, and Ramitec made them the suitable materials of choice of those tested, as the interocclusal registration record during CBCT scanning allowed clear visualization of barium teeth.

Clinical and Radiologic Features of Desmoplastic Ameloblastoma

To evaluate the clinical and radiologic features of desmoplastic ameloblastoma (DA). Twenty-four cases of DA among Chinese patients were analyzed retrospectively. The clinical and radiologic features of DA at present, as reported in the English-language literature, were reviewed and its radiologic characteristics critically evaluated. This study included 23 cases of intraosseous lesions and 1 case of extraosseous lesion. Clinically, DA is mainly located in the anterior and/or the premolar region of the jaw, with a slight male prominence. Among 23 intraosseous lesions, 9 cases occurred in the maxilla and 14 occurred in the mandible. Radiographically, 69.6% (16 of 23) exhibited ill-defined borders. Root displacement occurred in 47.9% of patients (11 of 23) and root resorption occurred in 8.7% of patients (2 of 23). Three radiologic presentations of DA were identified as follows: type I, which is both radiolucent and radiopaque in appearance (osteofibrosis type); type II, which has a completely radiolucent appearance (radiolucent type); and type III, which is both radiolucent and radiopaque in appearance combined with a large radiolucent change (compound type). The osteofibrosis type (14 cases) is the most common pattern, and the compound type is the least common (only 3 cases). DA has a potentially aggressive behavior. Moreover, it exhibits 3 different radiologic characteristics. Although DA should be differentiated from osteofibrosis lesions frequently described in the literature, some uncommon radiographic patterns should be considered in the differential diagnosis of this rare odontogenic tumor.

Prevalence of the pneumatized articular eminence in the temporal bone

The pneumatized articular eminence (PAT) of the temporal bone has been identified as an asymptomatic radiolucent appearance defect in the temporal bone. Although it occurs very rarely, when present, it may represent the potential for complications following surgical manipulation of the temporomandibular joint. The record of 8107 patients who presented to our Oral and Maxillofacial Surgery services, between January 1998 and February 2008 was reviewed. Observations were made on the side and radiographic appearance of the PAT; and sex and age of patients. Eighty-three of 8107 (1.03%) individuals had PAT with 41 females and 42 males. PATs were located on the right side in 60 individuals and in the left side in 50 individuals. PATs were unilateral in 56 cases and bilateral in 27 (totally 110 PAT). Forty-four of the PATs were unilocular type, and 66 of the PATs were multilocular type. Treatment of PAT is unnecessary. However if a surgeon who is planning to perform eminoplasty or eminectomy on a patient who has PAT, he/she should be aware of the details of PAT. Moreover, fractures of the temporal bone with PAT can occur easier than temporal bone without PAT.

A fatty tissue lesion of the floor of the mouth mimicking an odontogenic lesion

The floor of the mouth is a rare location for fatty tissue lesions. These lesions could cause resorption of the adjacent bone and lead to a radiolucent appearance on radiographs. In this case report, a non-capsulated lesion composed of mature adipose tissue located on the floor of the mouth causing a well-circumscribed oval radiolucent lesion close to the roots of the molar teeth due to resorption of mandible in a 33-year-old woman is reported.

Acroform type of enchondromatosis associated with severe vertebral involvement and facial dysmorphism in a boy with a new variant of enchondromatosis type I1 of Spranger: case report and a review of the literature

BackgroundEnchondromatosis represent a heterogenous group of disorders. Spranger et al attempted a classification into 6 types: Ollier disease, Maffuci syndrome, metachondromatosis, spondyloenchondrodysplasia, enchondromatosis with irregular vertebral lesions, and generalized enchondromatosis. Halal and Azouz added 3 tentative categories to the 6 in the classification of Spranger et al.Case presentationWe report on a 15-year-old boy with acrofrom upper limbs and mixed appearance of radiolucency, cysts and striae of fibro-chondromatosis. Lower limbs (femoral, tibial and fibular dysplasia showed enlarged metaphyses near the knees bilaterally) were present. Additional features of short stature, macrocephaly, facial dysmorphism, and generalised platyspondyly have been encountered. These bone shortenings were associated with bone bending, curving and rhizomelia of the upper limbs with significant macrodactyly. Limitations in articular movements were present. The forearm deformities were similar to those observed in hereditary multiple exostosis.ConclusionThe acrofrom upper limbs with mixed appearances of radiolucencies, cysts and striae of fibro-chondromatosis are the basic features of type I1Spranger. The constellation of facial dysmorphic features and significant vertebral abnormalities in our present patient were not compatible with the above-mentioned type of enchondromatosis. Our report widens the knowledge of disorders characterised by enchondromatosis. Ascertainment of the mode of inheritance in our present patient was difficult because of insufficient family history and parents declined clinical/radiographic documentation.

A preliminary study of angiographic classification and treatment of central arteriovenous malformations in jaws

To elaborate on the angiographic classification of central arteriovenous malformations (AVMs) in jaws, and to evaluate the correlation between this classification and treatment options. X-ray films and angiograms of 25 cases with AVMs in the jaw were retrospectively reviewed to evaluate the appearance of radiolucency, feeding arteries, nidus of the malformations and draining veins. Based on the findings a classification of angioarchitecture was recommended. Furthermore, the treatment results of these cases were reviewed to assess the correlation between this classification and treatment options. The angiographic pictures of 25 cases with central AVMs could be divided into five types: type I (n = 5) was with merely diffused micro-arteriovenous fistulas (AVFs); type II (n = 8) demonstrated a large venous pouch, all the feeding arteries drained into it; type III (n = 7) had a large venous pouch together with diffused micro-AVFs (I + II); type IV (n = 2) had multiple venous pouches; type V (n = 3) had multiple venous pouches and diffused micro-AVFs (I + IV). The angioarchitecture corresponded well to the radiographic appearance in all except one case. With respect to the treatment, type II, III, IV AVMs gained clinical cure in 100% of cases, whereas type I and type V AVMs obtained clinical cure only in 3 of 5 and 1 of 3 cases respectively. Central AVMs in jaws exhibited variant patterns of angioarchitecture, which could be divided into five types. Elaboration of this classification was helpful for decision-making on choosing appropriate therapy.

Ameloblastoma in young Jordanians: A review of the clinicopathologic features and treatment of 10 cases

Purpose: We sought to descriptively review the clinicopathologic features and surgical treatment of ameloblastoma in children and young adults of Jordan. Patients and Methods: Data were collected from the records of patients treated at the Oral and Maxillofacial Surgery Unit of Jordan University of Science and Technology between 1989 and 2002. Results: Ten patients (4 males and 6 females) were included in the review. All of the cases involved the mandibular molar-ramus region. The most common presenting sign was that of a painless swelling. In 5 of the patients, a multilocular radiolucent radiographic appearance was seen; the remaining 5 cases had a large unilocular radiolucent appearance. While 2 tumors were devoid of microcystic regions, 2 exhibited only a few scattered cystic foci, and 6 were entirely cystic (unicystic). Cases with a unilocular radiographic appearance were treated by surgical enucleation plus rotary instrument peripheral ostectomy. Cases with a multilocular radiographic appearance were treated by surgical resection without a continuity defect. During the follow-up period (average of 7.6 years), no recurrence or metastasis was detected. All patients had desirable postoperative function and appearance. Conclusion: The clinicopathologic patterns of ameloblastoma in these young Jordanians were found to be similar to those of other whites. In this case series, minimal surgical treatment of mandibular ameloblastoma resulted in no recurrence and excellent postoperative function and appearance. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:13-18, 2003

The Impact of Modularity in Total Hip Arthroplasty

Use of modularity in total hip arthroplasty has been of benefit in terms of allowing inventory reduction while providing surgeon versatility and thus optimal joint reconstruction. As with any advancement, the improvements gained must be weighed against their cost. The authors sought to examine the effects that modularity may have on the results of total hip arthroplasty in terms of bone loss, durability of fixation, time to failure, and incidence of revision. Using data from their total joint registry, the authors examined their experiences with total hip arthroplasties done during the past 25 years. They sought to compare the results of total hip arthroplasties in patients who differed chiefly by the number of modular junctions present in their hip prostheses. With each incremental increase in modularity, an earlier appearance of radiolucencies, an earlier occurrence of aseptic loosening, and an increased incidence of osteolysis in the absence of loosening was found. The authors conclude that suboptimal design rather than the concept of modularity best explains these results. The presence of suboptimal design in a total hip arthroplasty may cause polyethylene to be stressed beyond its performance limits.

Abscess Formation Around the Apex of a Maxillary Root Form Implant: Clinical and Microscopical Aspects. A Case Report

This case report describes the occurrence of an abscess in the periapical area of a root form maxillary titanium implant, with a radiolucent appearance and purulent discharge. The removal of the infected periapical tissues was carried out but the clinical symptoms of infection persisted, an attempt at guided tissue regeneration with a freeze-dried dura mater membrane notwithstanding, and it was necessary to remove the implant. The microscopical examination showed that it was possible to observe nonviable bone tissue, with absence of bone cells and areas of bone resorption in the apical portion of the implant. These microscopical features were compatible with an acute localized suppurative osteomyelitis.