A teratoma is a true neoplasm composed of multiple tissues foreign to the sites from which they originate. The estimated incidence of mature congenital teratomas at all sites is 1 in 4000 live births, of which at least 2% are oropharyngeal. An epignathus tumor is a congenital malformation classified as a mature teratoma. The incidence of epignathus is much rarer, estimated from 1:35,000 to 1:200,000 live births and has a female predominance. Teratomas, by definition, are neoplasms that consist of all 3 germ cell layers, and in the case of epignathus teratomas, the germ cell layers are mature differentiated tissue. A 1-day-old infant presented to us with giant epignathus that arose from the palate and extended to the lateral oropharynx and to the tongue. The tumor did not cause immediate respiratory obstruction, but there was difficulty with feeding. At the fifth day of the baby's life, the tumor was excised completely under general anesthesia through an endotracheal intubation.
Clefts of the lip, alveolus, and palate are the most common congenital malformation of the orofacial region. Bone grafting of the alveolar cleft is necessary for rehabilitation of oral function. Platelet rich fibrin (PRF), an autologous fibrin matrix is a secondgeneration platelet concentrate that has a positive effect on bone healing.Aim of the Study: The aim of this prospective study is to investigate and evaluate the quality and quantity of the bone graft that mixed with PRF when used in reconstruction of alveolar cleft in terms of bone density and resorption rate of the bone graft. Materials and Methods: Sixteen patients with unilateral alveolar clefts were treated. The control group received bone grafts without PRF, while the remaining patients comprised the PRF group and received grafts with PRF. Postoperative bone graft density and rate of bone resorption were assessed by CBCT at 1 month and 6 months after surgery Results: Satisfactory bone bridging formation was observed in all patients and the mean of bone resorption in PRF group within 6 months after surgery lower than control group. The bone density of the PRF group was lower than that of the control group at 1 st month, which later after 6 months increased to be more than the control group. Conclusions: Platelet rich fibrin that mixed with autogenous bone graft was significantly reduce postoperative bone resorption. PRF may provide a higher bone density in the long postoperative course.
Soft tissue changes were observed in all patients. There was highly significant increase in tragus-commissure line in all patients, significant increase in lateral canthus-commissure line in 10 patients, and significant increase in medial canthus-commissure line and lower lip length in 9 patients. The lines' relation with the overjet was highly significant in right side of tragus-commissure line, lateral canthus-commissure line, medial canthus-commissure line, and lower lip length, and significant in left side of tragus-commissure line, lateral canthus-commissure line, and medial canthus-commissure line CONCLUSION:: Distraction osteogenesis has recognizable effect on facial soft tissue profile in addition to its effect on skeletal structure.
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