Professional Documents
Culture Documents
Ruggero Rodriguez y Baena, MD, DDS,a Silvana Rizzo, MD, DDS,b Giacomo Fiandrino, MD,c
Saturnino Lupi, DDS,d and Silvestre Galioto, MD,e Pavia, Italy
UNIVERSITY OF PAVIA
An osteoma is a slow-growing, benign lesion comprising mature bone tissue. Osteomas rarely occur in
maxillary bones, with the exception of the maxillary sinuses. Various possible etiologies have been proposed,
including congenital anomalies, chronic inflammation, muscular activity, embryogenetic changes, and trauma. Here
we present a case of an osteoma of the buccal plate of the mandible at the site where a sports-related traumatic injury
occurred 15 years earlier. Both conventional and 3-dimensional x-ray examinations were used for diagnosis and
preoperative evaluation of the possible involvement of the adjacent anatomic structures. The lesion was treated
surgically without complications and the patient made a complete recovery. Histologic tests confirmed the
preoperative diagnosis. A review of the international literature is also presented. (Oral Surg Oral Med Oral Pathol
Oral Radiol Endod 2011;112:e44-e48)
Associate Professor of Clinical Dentistry, Oral Surgery, and Implantology, Department of Oral Sciences S.Palazzi, University of Pavia,
Pavia, Italy.
b
Full Professor of Oral Surgery, Department of Oral Sciences S.Palazzi, University of Pavia, Pavia, Italy.
c
Researcher, University of Pavia, Anatomic Pathology Section, Department of Human and Hereditary Pathology, Pavia, Italy.
d
Dentist, Department of Oral Sciences S.Palazzi, University of
Pavia, Pavia, Italy.
e
Associate Professor of Oral & Maxillofacial Surgery, Department of
Oral Sciences S.Palazzi, University of Pavia, Pavia, Italy.
Received for publication Jan 23, 2011; returned for revision May 1,
2011; accepted for publication May 19, 2011.
1079-2104/$ - see front matter
2011 Mosby, Inc. All rights reserved.
doi:10.1016/j.tripleo.2011.05.006
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Fig. 1. Preoperative clinical presentation with evident swelling in the mandibular zone (arrow).
CASE HISTORY
The patient was male, aged 25 years, who presented with
evident swelling of the right cheek. His previous history
included trauma to the right mandible during a baseball game
when he was 10 years old. The hematoma was notable. The
lesion was noticed by the patient 5 years earlier and had
shown slow and progressive growth until a visible deformity
could be seen in the right genial zone, causing concern to the
patient (Fig. 1). General clinical examination showed no
changes in organs or systems, and laboratory tests were
normal. Local examination showed a painless, cherry-sized
swelling in the right mandibular zone. The swelling was of a
hard bony consistency and was firmly attached to the mandible. There were no painful symptoms or lesions of the perioral
skin or the oral mucosa. The patient could open his mouth
normally without any deviations. A panoramic x-ray examination and posterior-anterior (PA) cranial x-ray examination,
which revealed the bony origin of the lesion, were performed
(Figs. 2 and 3). A CT scan was performed to allow for a more
accurate diagnosis (Figs. 4-6) (CT scanner: Siemens Somaton
Definition, Siemens Spa, Milan Italy; pixel size: 0.2441, field
of view: 12.50, algorithm: H60s). The lesion was located in
the mandible on the buccal plate, distal to the mandibular
foramen, above the external oblique line. The maximum
diameter of the lesion was approximately 1.5 cm. Radio-
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given precise oral hygiene guidelines. The healing was uneventful and no complications were observed (Fig. 9). Histologic tests confirmed the preoperative diagnosis and showed
compact mature bone (Figs. 10 and 11). The postoperative
follow-up consisted of an annual clinical check-up and x-ray
examination (PA projection).
DISCUSSION
Only 4 cases of peripheral osteoma of certain traumatic origin are reported in the literature, 3 of which
were at the mandibular angle9,30 and 1 in the lingual
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eration of the tissues involved. The patients complete recovery and nonrelapse must be confirmed by
long-term follow-up.
CONCLUSIONS
A peripheral osteoma of traumatic origin is a rare
benign lesion of the mandible and few cases are reported
in the literature. The presented case seems to confirm that
the origin of the lesion was a trauma that had occurred 15
years earlier. An accurate preoperative study was performed using conventional and 3-dimensional radiographs
and represented the base for a correct diagnosis and the
surgical strategy. Although osteomas are benign lesions,
long-term follow-up should be performed to confirm complete recovery.
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Reprint requests:
Ruggero Rodriguez y Baena, MD, DDS
Department of Oral Sciences S.Palazzi
University of Pavia
P.le Golgi 2
27100 Pavia, Italy
ruggero.rodriguez@unipv.it