HighlightsCentral giant cell granuloma is considered one of the giant cell lesion affecting the oral cavity with variable histological forms; may be aggressive or non-aggressive.Many studies consider giant cell granuloma the same entity as giant cell tumor of long bones.Different treatment modalities arise due to its different histological and clinical behavior. Treatment may be medical or surgical.Intralesional injection is one of the medical lines used in management of CGCG; with high success and no side effects.In our clinical case, Cushing developed in 9 years old patient forced our team to shift toward surgical line and stop intralesional steroid injections.
Introduction:
Distraction osteogenesis is an integral part in management of mandibular defects associated with hemifacial microsomia and post-ankylotic mandibular defects. The most difficult part in distraction osteogenesis is the prediction of distraction vector and risk of injury to vital structures as inferior alveolar. The present study aimed to present 3-dimensionally constructed computer-guided splints in distraction osteogenesis to get an ideal vector and minimal risk of vital structures injury.
Material and Methods:
The technical note presents cases series of 6 patients who had computer-guided distraction osteogenesis surgery using prefabricated splints.
Results:
The distance between the virtual and physical pins and osteotomy was measured, and the deviation of the vector angle and osteotomy angle was also assessed. Average deviation in pin distance was 3 mm and in vector angle 13.5°. Average deviation in osteotomy distance was 2.6 mm and in osteotomy angle 14.4°. None of the cases had injury to vital structure. There was significant improvement (P = 0.0078) in the medial canthus–buccal commissure distance where the arithmetic mean improved from 59.6 (SD = 10.1) mm pre-distraction in the defective side to 67.1 (SD = 8) mm post-distraction. The degree of correction was 97% compared to the normal side.
Conclusion:
3D printed surgical stents were successful in transferring the virtual treatment plan of mandibular distraction osteogenesis into the surgical theatre with an acceptable margin of error and without injury to any vital structures
Distraction osteogenesis (DO) bone regenerate usually suffers from an inferior quality especially with rapid rate. This study was conducted to investigate the effect of mesenchymal stem cells (MSCs) application on different rates of distraction bone quality. Twenty-four goats were divided into group A with standard DO and group B with rapid distraction osteogenesis (RDO) both aided by MSCs. Group C with standard DO and group (D) with RDO were controls. Kruskal-Wallis test and Conover's post hoc analysis was used to evaluate significance ( = 0.05). Histomorphometry showed a strongly significant (SS) increase ( = 0.00036) in trabecular bone (TB) in group A (TB = 174.7 µm, SD = 33.5) and group B (TB = 166.8 µm, SD = 14) compared with group C (TB = 115.4 µm, SD = 19.6) and group D (TB = 86.1 µm, SD = 9.3). There was SS decrease ( = 0.00093) in osteoid percentage (OP) in group A (OP = 13.4%, SD = 2) and group B (OP = 11.5%, SD = 6.5) compared with group C (OP = 27.3, SD = 3.5) and group D (OP = 26.2%, SD = 2.6). Energy dispersive X-ray showed a nonsignificant increase ( = 0.11) in calcification (Ca %) in group A (Ca % = 17.6%, SD = 4.9) and group B (Ca % = 17.6%, SD = 4.3) compared with group C (Ca % = 14.2%, SD = 6.7) and group D (Ca % = 11.5%, SD = 2.4). MSCs application improved microscopic bone quality during standard DO and RDO. However, macroscopic bone quality improvement still needs further investigation.
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