Odontogenic origins are rarely implicated in the formation of brain abscesses. The relative paucity of this kind of infection and the difficulty in matching the causative microorganisms of a brain abscess to an odontogenic source can explain the late management of patients. We herein describe a case of a 46-year-old man with a cerebellar abscess that was probably due to an odontogenic infection. The diagnosis supported by imaging and microscopic identification, mini craniectomy for abscess drainage followed by eradication of all potential dental infectious foci, and an antibiotic regimen based on cephalosporins, metronidazole, and vancomycine contributed to a successful outcome.

-Introduction:Intentional replantation is a recognized endodontic procedure in cases in which root canal and surgical endodontic treatments are not recommended. Although not frequently used, intentional replantation is a treatment option that dentists should consider. Three keys point should be keep in mind to ensure the success of replantation procedure. To overcome any complications, the surgical procedure have to be rigorous, the extra-alveolar time properly managed, and the splint adapted. In the other hand, the knowing of the indications and the advantages is advocated for the success of this procedure. Conclusion: When standard protocols of intentional replantation are followed, clinical and radiological success is expected. From this point of view, intentional replantation should be considered as a viable therapeutic and not as a procedure of last resort

RÉSUMÉUne patiente âgée de 20 ans consulte pour une tuméfaction parasymphysaire gauche évoluant depuis quelques mois. L'examen clinique montre une tuméfaction dure et indolore avec, à l'examen endobuccal, un comblement du vestibule allant de la 33 à la 36 avec absence de la 34. Les dents de voisinage sont vivantes. L'examen radiologique révèle une image radioclaire uniloculaire en rapport avec la couronne de la 34 qui est incluse.

Objective. The aim of this study was to investigate the prevalence and characteristics of oral lichen planus (OLP) and oral lichenoid lesions (OLL) in Sjogren’s syndrome (SS) patients. Patients and Methods. A prospective clinical study was conducted at the Department of Oral Medicine and Oral Surgery in Sahloul Hospital, Sousse, from January 2012 to June 2018. The patients involved in this study were diagnosed with Sjogren’s syndrome according to the AECG (American-European consensus group) diagnostic criteria. Among these patients, we searched for those affected by OLP or OLL as determined by the WHO (World Health Organisation) classification of 2003. Clinical variables such as age, sex, medical conditions and medications, type of SS (primary or secondary), clinical form of OLP, and treatment were analyzed. The assessment of the results was performed using SPSS software. Results. We evaluated 30 patients (27 females and 3 males) diagnosed with SS (24 had primary SS) with a mean age of 55 years and 11 months (±11,714). Overall, 9 patients had oral lesions (30%). Two patients had OLP associated with secondary SS (25%). Primary Sjogren’s syndrome patients had 6 OLP lesions and one erythematous lichenoid lesion. OLP was erosive in eight patients, among them two had vulvo-vaginal-gingival syndrome. OLP lesions showed improvement in symptoms after topical or general corticosteroids treatment, while OLL showed improvement only under antibiotic treatment. Conclusion. The results of our analysis suggest that patients with SS have 30% prevalence of OLP and OLL. This possible association shows the importance of screening for oral dryness in patients with OLP or OLL. Treatment includes topical or general corticosteroids for erosive forms associated or not with topical antifungal treatment to treat or prevent oral candidiasis.

Oral cancer is a growing public health problem, it is increasing worldwide since it is the sixth most common cancer overall. The highest rates of oral cancer occur in the most disadvantaged sections of the population. Early detection and screening have been shown to be effective in reducing mortality and morbidity caused by oral cancers. To ensure early detection of oral cancer measures such as mass screening or screening of high-risk group population; reducing the delay from patients´ side by creating awareness about signs and symptoms of oral cancer. Today, no national population-based screening programs for oral cancer have been implemented yet. The objectives of this project are to evaluate and educate Tunisian Dentists as well as health professionals to perform oral screening and early detection of suspicious oral lesions in order to reduce morbidity and mortality associated with oral cancer.

Introduction Brown tumors of hyperparathyroidism are locally destructive bone lesions. They are the late clinical consequence of the disease. They can occur in primary, secondary, and rarely tertiary forms. They affect usually long bones and less frequently those of the maxilla. Case Report Our 45-year-old female patient presented with a mandibular tumor next to the first right lower molar. At first, we have chosen tooth extraction and tumor excision. When the histological report showed the giant cell tumor we suspected a metabolic bone disorder. Biochemical tests screened hyperparathyroidism and severe vitamin D deficiency, and parathyroid scintiscan revealed parathyroid adenoma. Discussion The association of hyperparathyroidism and vitamin D deficiency leads to diagnostic uncertainty. First, secondary hyperparathyroidism can be due vitamin D deficiency. Second, data available show that vitamin D deficiency is more prevalent in patients with primary hyperparathyroidism than in general population. Hyperparathyroidism management is based on correct and precise diagnosis. Furthermore, the resolution of brown tumors depends on the cure of hyperparathyroidism. In fact, bone lesions should regress after biological tests' normalization. Conclusion Clinicians should be aware of such rare and complicated presentation. They must consider the diagnosis of the brown tumor to avoid extensive surgical excision and teeth extractions.

Background: Dentigerous cysts are seen as benign pathology associated with developing, unerupted teeth. Individuals affected present with slow growing expansion of the bone, straw-coloured fluid on aspiration and displacement of involved and adjacent teeth. Case Report: An 11-year-old boy was referred with a painless reddish mass of three months duration. Examination revealed mild, diffuse swelling over the left maxillary region with an erythematous, soft tissue sessile swelling intraorally. Orthopantomograph showed radiopacity over the left maxillary sinus with displaced 27, 28 crowns. Contrast computed tomography (CT) and angiography identified feeder vessels from the branches of the left internal maxillary artery. Treatment and Follow-up: Embolisation was performed initially to block the supplying artery. Enucleation of the lesion followed three days post-embolisation. A histopathological examination of the lesion was carried out once enucleation complete. A review and monitoring programme was followed at three-, six-and ninemonth intervals. Conclusion: Judicial use of contrast CT and angiography can aid accurate diagnosis of erythematous oral growths in young patients.

RÉSUMÉUn patient âgé de 18 ans consulte pour une macrochéilite supérieure évoluant par poussées sans que la lèvre reprenne son aspect normal entre les poussées. L'anamnèse révèle un antécédent de paralysie faciale péri-phérique gauche. L'examen endobuccal montre entre autres une langue plicaturée et un oedème gingival. Devant cette triade symptomatique, le diagnostic clinique du syndrome de Melkersson-Rosenthal a été éta-bli. La récidive de l'oedème a soulevé des difficultés thérapeutiques. L'enquête auprès de la famille du patient a permis d'établir l'arbre généalogique permettant de retrouver ces atteintes chez certains membres de cette famille. Med Buccale Chir Buccale 2007 ; 13 : 29-34. mots clés : syndrome de Melkersson-Rosenthal, paralysie faciale, oedème, granulomatose.