International Poster Journal of Dentistry and Oral Medicine, 01/2025

Introduction: Resection of oral cancer is a surgical intervention involving the removal of the cancer in order to restore oral health and function, aiming to preserve aesthetics and maintain quality of life for the patient. Given the complexity and critical nature of oral cavity resections, effective communication and documentation and well-structured reports are paramount. The College of American Pathologists (CAP) and the Royal College of Pathologists (RCPath) are the two most commonly used standardised guidelines for reporting oral cavity resections and serve as an essential tool for conveying crucial information among multidisciplinary teams, guiding postoperative care, and facilitating long-term patient management. Objective: To enumerate and highlight the data elements in the reporting of oral cancer resection specimens in CAP versus RCPath. Methodology: Different components of the included protocols as per CAP (June 2023) and RCPath (October 2023) will be discussed. Results: New areas or columns of emphasis in reporting as per CAP and RCPath guidelines will be highlighted. Conclusion: Every oral pathologist should be aware of, and from time to time updated on, the reporting of oral cancer resections in order to establish uniform data and a standardized way of reporting worldwide. Keywords: CAP guidelines, RCPATH guidelines, oral cancer, resection margins

Marcus Gunn syndrome, or mandibulopalpebral synkinesis, is a congenital movement of the upper eyelid when the mouth is opened. The cause is a paradoxical ipsilateral innervation between the eyelid retractor and the lateral pterygoid muscle. Clinically, there is ptosis of the affected eyelid, which disappears when the mouth is opened. The inverse Marcus-Gunn phenomenon describes an ipsilateral closure of the eyelid when the lateral pterygoid muscle contracts. The combination of both phenomena is also known as ‘See-Saw’ Marcus Gunn syndrome. This is a congenital condition that leads to lifting of the upper eyelid on one side and lowering of the upper eyelid on the opposite side when the mouth is opened. This condition is considered an extreme rarity. In this case report, we show a twenty-year-old woman who has had the condition from birth. At rest, there is incomplete ptosis of the right eye. When the mouth is opened, the right eyelid lifts involuntarily and the left upper eyelid lowers almost completely. In addition, she shows a bilateral involuntary pupil movement to the left caudal side. A causal therapy is not yet known, genetic counselling is recommended. Therapeutic approaches relate to independent conscious training of the dysinervated eyelid in front of the mirror; in severe cases, surgical correction may be considered. Keywords: MGS, rare phenomenon, mandibulopalpebral synkinesis

Peripheral extraosseous ameloblastoma is the rarest subtype of ameloblastoma, accounting for 1-2% of cases. We report a case in which a peripheral ameloblastoma of the acanthomatous type occurred at the same site of a previously removed central ameloblastoma. The patient had a central ameloblastoma of the right mandibular angle removed 15 years ago. The patient underwent clinical and radiological follow-up, initially every six months and then every year, which ended eight years ago. On the advice of her family dentist, the patient presented again with an exophytic mucosal change in the area of the former resection site. A sample was taken and a histological examination was performed, which revealed a peripheral ameloblastoma of the acanthomatous type; a microscopically complete removal could not be assumed due to marginal cell nests. Due to the rarity of the findings, there is no clear consensus regarding the necessary radicality of the removal. In this case, a subsequent resection was dispensed with in favour of close clinical and radiological follow-up; a six-monthly follow-up interval was again specified. Keywords: ameloblastoma, case report, acanthomatous type

This case report highlights a 55-year-old female patient presenting with pain and pus discharge from the right side of her face. The patient exhibited diffuse bony lesions characterised by significant bone expansion and exposed mandibular alveolar bone covered with slough. A CT scan revealed radioopaque masses scattered throughout the mandible and maxilla, with radiographic features similar to chronic sclerosing osteomyelitis. Histological examination showed formations of dense sclerotic calcified cementum-like masses. The lesion comprised cementum-like substances with islands of calcified deposits and areas of loose fibro-collagenous stroma. Additionally, this report includes a 28-year-old male patient with spacing and malpositioned teeth. Extra-oral examination revealed a slight maxillary deficiency, while intraoral examination showed a high frenum attachment between the maxillary central incisors, missing first molars on both sides, and a retained maxillary deciduous second molar on the left side. Based on the history, clinical features, radiographic findings, and histological report, a final diagnosis of familial florid cemento-osseous dysplasia (FCOD) was made. These cases underscore the importance of comprehensive diagnostic approaches, including clinical, radiographic, and histological evaluations, in accurately diagnosing and managing complex odontogenic lesions. Keywords: familial florid cemento-osseous dysplasia, cementum-like masses, cemento-osseous dysplasia

Background: Children's psycho-social health is significantly affected by dental pain. Measurement of discomfort affects the required management of pain; therefore, a reliable tool is required to assess pain which is well-accepted by paediatric dental patients. Aim: The aim of this study was to assess pain by two novel methods in children. Materials and Methods: The current study included twenty healthy children aged 6-9 years requiring local anaesthesia administration were recruited. Two different scales [Wong-Bakers FACES Pain Scale (WBFPS) and Memojis Pain Scale (MPS)] were applied to assess the children's pain during the administration of local anaesthetic. Results: Statistical analysis was conducted in which there was no significant difference found between the WBFPS and MPS groups. Conclusion: The WBFPS and MPS were equally effective and acceptable pain assessment tools for the children receiving local infiltration. Keywords: dental pain, Wong-Bakers FACES Pain Scale, Memoji pain scale

Mature teratoma in newborns is a very rare but highly aesthetically impairing, functionally limiting and potentially life-threatening entity in the craniofacial region which can be classified into grades 0-3 according to Gonzalez-Crussi. Due to the rarity and complexity of the clinical picture, as well as balancing necessary radicality and potential mutilation, we present a multidisciplinary management concept. The case series comprises three patients in whom an extra- and intraoral neoplasia was detected during the neonatal period, necessitating intensive care and surgical reduction of the mass. Preoperatively, in addition to obtaining samples and histologically confirming the diagnosis, an MR examination was performed in all cases to plan the surgical procedure. In all three cases a mature teratoma, G0 according to Gonzalez-Crussi, was detected. Repeated discussions were held at the interdisciplinary tumour conference during treatment. The resections were carried out in accordance with the treatment protocols of the MAKEI V study centre. After resection, in all three cases an immediate improvement in function and aesthetic correction was achieved, enabling oral feeding and regular development of the child. No mutilating surgery was planned, and therefore a complete resection was not attempted. All patients are undergoing multidisciplinary, long time follow-up care according to the individual risk. Keywords: tumour, teratoma, paediatric, maxillofacial

Introduction: If impacted teeth show a close relationship to the inferior alveolar nerve, surgical removal poses a high risk of nerve damage. Performing a coronectomy, which leaves the root in place, can reduce this risk. This case demonstrates a coronectomy followed by implant-prosthetic rehabilitation. Materials and Methods: A patient presented with a distoangulated impacted tooth 45 and secondary caries on the mesial crown margin of tooth 47. Teeth 45 and 46 had been replaced by pontics for decades, with teeth 44 and 47 serving as abutments. 3D imaging showed the inferior alveolar nerve enclosed by the root of tooth 45. A coronectomy on tooth 45 was recommended and performed under IV sedation and perioperative antibiotics. A bony lid was created using the MicroSaw. The tooth crown and the coronal third of the root were removed, and the remaining root was left in place due to its proximity to the nerve. The bony lid was repositioned. After healing, tooth 47 was removed following the failure of a preservation attempt. Two months postoperatively, implantation was performed in regions 45 and 47 with bone augmentation using the split bone block Ttechnique and bone core technique. Autologous bone was harvested locally at the implantation site and from the ipsilateral retromolar area. After implant exposure, prosthetic restoration was completed without any sensory impairment. Conclusion: A coronectomy can be an alternative to complete tooth removal when there is a close relationship with the inferior alveolar nerve. The bony lid approach preserves surrounding bone and enables subsequent implantation. Keywords: coronectomy, case report, split bone block technique, autologous bone, bony lid

The cutaneous horn is a clinical finding rooted in a variety of different benign and malignant causes. Sampling with subsequent histologic examination is the diagnostic gold standard. Depending on the causing pathology, different therapies are necessary. We report a case in which a patient presented to our outpatient clinic with two cutaneous horns of the lower lip. A biopsy had already been performed in another clinic five years ago, in which a not fully excised, well-differentiated squamous cell carcinoma (G1), was found. The patient refused further surgical treatment recommendations at the time. Due to the size-progressive and functionally limiting findings, the patient presented to our clinic. After removal of the lesions, a histological examination was performed. Apart from verrucous hyperplastic squamous epithelium, no evidence of malignancy was histologically found. As there were no histologically visible signs of malignancy, the patient was discharged in an aesthetically and functionally acceptable state into a follow-up program with clinical check-ups every six months in order to detect and remove any recurrences at an early stage. Keywords: cornu cutaneum, cateneous horn, squamous cell carcinoma, lower lip

Primary failure of eruption is a genetic partial eruption disorder that leads to an open posterior bite. The clinical severity and manifestation of primary failure of eruption are variable. The correct diagnosis of this eruptive anomaly plays an essential role in treatment planning, which can be prosthetic, orthodontic, surgical or multidisciplinary. The aim of this study was to determine the extent to which adequate treatment can be derived from the radiologic presentation of the PFE in the orthopantomogram. Preoperative panthomogram images were evaluated in 42 patients with confirmed PFE. The basis for treatment decisions was defined as follows: Evaluation of the affected teeth, evaluation of the bone, occlusal lines in the posterior region. Treatment can be standardised on the basis of orthopantomogram images in patients with PFE. We were able to derive the following treatment options from the orthopantomogram images: If the teeth are slightly below the occlusal plane, prosthetic treatment is indicated; in the case of a negative occlusal line in the mandible and also in the maxilla, extraction / augmentation / implantation / prosthetics should be selected as a treatment option; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, a bimaxillary repositioning osteotomy would be indicated; if the occlusal plane is displaced caudally in the mandible and cranially in the maxilla, distraction or a segmental osteotomy with fixation would be indicated. The evaluation of orthopantomogram images of confirmed primary failure of eruption patients has shown that criteria can be defined that lead to standardisation and simplification of treatment. Keywords: orthopantomogram, primary failure of eruption, PFE, treatment decisions, treatment standardised

Acute myeloid leukaemia (AML) is an acute disease in which B-symptoms such as weakness, fever, and night sweats usually appear early in the case history. However, subtypes of AML can present with specific symptoms, for example in the form of gingival hyperplasia. Sampling (PE) with histological examination is considered the gold standard of diagnosis. We report a case in which a patient with gingival hyperplasia in region 17-13 presented in September 2023. The PE performed revealed the presence of a chloroma (syn. myeloblastoma or granulocytic sarcoma), which is the extramedullary manifestation of AML or an AML-related syndrome. The patient was then referred to the oncology day clinic. After further diagnostics, AML with an NPM1 mutation was detected and the patient was transferred to oncology treatment. A complete inspection and palpation of the oral cavity is essential for the early detection of (malignant) changes. In addition, systemic diseases often show oral manifestations as an initial or accompanying symptom. Here, the dentist can play a decisive role in quickly establishing the diagnosis. If lesions show no tendency to heal within two weeks despite adequate treatment, the previously made (suspected) diagnosis and the cytological or histological findings must be questioned and repeated if necessary. Keywords: acute myeloid leukaemia, AML, oral manifestation