Leiomyomas are benign tumors arising from smooth muscle, most commonly seen in uterine myometrium, gastrointestinal tract, skin and lower extremities of middle-aged women. Leiomyomas are uncommon in the oral cavity with reported incidence of 0.065%, which accounts for 0.42% of all soft-tissue neoplasms in the oral cavity. Leiomyomas of head and neck region account for less than 1% of all leiomyomas. The most common site of leiomyoma in the head and neck region is the lips (27.46%) followed by tongue (18.30%), cheeks and palate (15.49%), gingiva (8.45%) and mandible (5.63%). The purpose of this article is to present three cases of leiomyoma comprising of an intraoral vascular leiomyoma and two solid leiomyomas in the head and neck region. The clinical features, etiology, differential diagnosis and treatment of leiomyoma are discussed with review of the literature.
The transfer of autologous fat has been performed since the 1890s; however, its popularity has increased owing to better understanding of fat harvesting and processing techniques. In this article, fat grafting procedure has been used to correct posttraumatic facial deformities in 25 cases. As healing of grafted fat is unpredictable, we have used longer follow-up of 2 years. Evaluation was performed using facial photographs and MRI scans. Scientific literature describes an absorption rate ranging from 20 to 90%. High fat graft resorption rates have been attributed to traumatic handling of the graft during harvest, processing, and injection. Various processing techniques have been suggested. The goal of these techniques is to obtain greater adipocyte cell survival and, consequently, more reliable clinical results. In our study, we have used syringe aspiration and low-speed centrifuge for processing of fat which has resulted in good clinical outcomes.
Objective:
This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects.
Materials and Methods:
This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3
rd
, and 5
th
month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4
th
, 6
th
, and 9
th
month postoperatively.
Results:
PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing.
Conclusion:
Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.
Augmentation rhinoplasty can be carried out using a wide range of materials including autologous bone and/or cartilage as well as alloplasts. Use of biologic bone and cartilage grafts results in lower infection rates, but they are associated with long-term resorption and donor-site morbidity. Alloplastic materials, in particular silicone, have been associated in literature with extrusion, necrosis of the tip, mobility and deviation or displacement of the implant, immobile nasal tip and infection. However, they have the advantages of being readily available and easy to reshape with no requirement for harvesting autografts.Aim:To overcome these problems associated with silicone implants for which the authors have devised a novel technique, the “rideon technique”.Materials and Methods:The present study was carried out on 11 patients over a period of 4 years. The authors have devised a simple technique to fix the silicone implant and retain it in place. Restricting the implant to only dorsum avoided common complications related to the silicone implant.Results:The authors have used this technique in 11 patients with encouraging results. Follow-up ranged from 12 months to 36 months during which patients were assessed for implant mobility, implant extrusion and tip necrosis. There was no incidence of above mentioned complications in these patients.Conclusion:The “rideon technique” provides excellent stability to silicone implants and restricting the implant only to dorsum not only eliminates chances of tip necrosis and thus implant extrusion but also maintains natural shape, feel and mobility of the tip.
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