To identify the risk factors of conjunctival malignant melanoma that predict local tumor recurrence, orbital exenteration, distant metastasis, and tumorrelated mortality. Design: The clinical parameters of the patient, tumor, and treatment were analyzed in a nonrandomized fashion for their relation to 4 main outcome measures using Cox proportional hazards regression models. Participants: One hundred fifty consecutive patients. Main Outcome Measures: Local tumor recurrence, orbital exenteration, distant metastasis, and death from conjunctival melanoma. Results: The Kaplan-Meier estimates of local tumor recurrence was 26% at 5 years, 51% at 10 years, and 65% at 15 years. The mean number of recurrences per patient was 1 (median, 0 recurrences). There was no recurrence in 98 patients (65%), 1 recurrence in 28 patients (19%), 2 recurrences in 11 patients (7%), 3 recurrences in 5 patients (3%), and 4 or more recurrences in 8 patients (5%). Using multivariate analysis, the factors correlated with local tumor recurrence were melanoma location (not touching the limbus) (P =.01) and pathological tumor margins (lateral margin involved) (P=.02). Multivariate analysis for features correlated with ultimate exenteration included initial visual acuity (20/40 OU or worse) (PϽ.001), melanoma color red (P =.01), and melanoma location (not touching the limbus) (P=.02). Tumor metastasis was present in 16% of patients at 5 years, 26% of patients at 10 years, and 32% of patients at 15 years. Metastasis was first located in the regional lymph nodes in 17 cases, the brain in 4 cases, the liver in 3 cases, the lung in 2 cases, and was disseminated in 1 case. The risks for metastases using multivariate analysis included pathological tumor margins (lateral margin involved) (P = .002) and melanoma location (not touching limbus) (P =.04). Tumor-related death occurred in 7% patients at 5 years' follow-up and 13% at 8 years' follow-up. The risk factors for death using multivariate analysis included initial symptoms (lump) (P = .004) and pathologic findings (de novo melanoma without primary acquired melanosis) (P=.05). The technique of initial surgery was shown to be an important factor in preventing eventual tumor recurrence (P=.07), metastasis (P=.03), and death (P=.006) in the univariate analysis, but did not reach significance in the multivariate analysis. Conclusions: Conjunctival malignant melanoma is a potentially deadly tumor. In the present study, metastasis was detected in 26% of patients, and death occurred in 13% of patients at 10 years. Extralimbal melanoma and tumor involvement of the surgical margins were especially poor prognostic factors. Meticulous surgical planning using wide microsurgical excisional biopsy working with the "no touch" technique and supplemental alcohol corneal epitheliectomy and conjunctival cryotherapy is advised.
The presence of an unerupted supernumerary tooth, or tooth bud between the 2 central incisors or as unilateral or bilateral teeth in the midline of the maxilla was noted as mesiodens on radiographs. Eighty-five cases of mesiodens in 69 patients were found. Complete documentation, including radiographs, for these 69 patients were studied and analyzed. In addition to gender and age, the following information about the mesiodens was recorded: 1) number; 2) shape; 3) position; 4) complications caused by the mesiodens; 5) treatment. Of the 69 patients, the ratio of boys (47 cases) to girls (22 cases) was 2.1:1. Fifty-three (76.8%) of the children had 1 mesiodens, and 16 (23.1%) had 2 mesiodentes bilaterally to the midline. Of the 85 mesiodentes, 67 (78.8%) were fully impacted, 6 (7%) were partially erupted, and 12 (14.1%) were fully erupted. Most of the mesiodentes (55.2%) were found in the vertical position, followed by inverted position (37.6%), and horizontal position (7%). The main complications were delayed eruption of the permanent incisors (38.8%), maxillary midline diastema (17.6%), axial rotation or inclination of erupted permanent incisors (16.4%), and resorption of the adjacent teeth (4.7%) The prevelance of mesiodens has been estimated to be 0.15% to 2
Objective: To determine the relative frequency and distribution of odontogenic and nonodontogenic cysts in a large Turkish population. Study Design A retrospective survey of jaw cysts was undertaken at the Oral Diagnosis and Radiology and Oral and Maxillofacial Surgery Department, Ondokuz Mayıs University Dental School, Samsun, Turkey. Data were retrieved from clinical files, imaging, and histopathology reports from 2000 to 2008; a total of 12,350 patients were included. In each case, we analyzed age, gender, type and number of cysts, and cyst location. Imaging patterns and pathologies associated with cystic lesions were also determined. Results: The prevalence of odontogenic and nonodontogenic cysts was 3.51%; males were affected more frequently than females. There were 452 odontogenic cysts (98.5%) and seven nonodontogenic cysts (1.5%). The most frequent odontogenic cyst was radicular (54.7%), followed by dentigerous (26.6%), residual (13.7%), odontogenic keratocyst (3.3%), and lateral periodontal cyst (0.2%). Nasopalatine duct cyst (1.5%) was the only nonodontogenic cyst. By age, cysts peaked in the third decade (24.2%). Concerning location, no statistically significant difference was found between the maxilla and mandible (p>0.05). The most frequent radiological feature of these lesions was unilocular cyst (93.7%). Pathologies associated with cystic lesions occurred in 14.7%. Conclusion: The prevalence of both odontogenic and nonodontogenic cysts were lower than that reported in many other studies. In our study population, cysts were mainly inflammatory in origin. Key words: Prevalence, odontogenic, nonodontogenic, cysts.
Pre-eruptive intracoronal resorption defects occurred in 40 subjects. Increased awareness and careful radiographic examination of unerupted teeth may improve early detection and treatment of PIR defects.
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