Central odontogenic fibroma(COF) is an extremely rare benign tumor that accounts for 0.1% of all odontogenic tumor. COF is regarded by the World Health Organization(WHO) as a benign odontogenic neoplasm derived from mesenchymal odontogenic tissue. The lesion occurs most commonly in the mandible and patients ranging in age from11 to 80years with mean age of 34years. In this article, we report two case of COF. Case I was associated odontoma and impacted tooth. Odontoma and impacted tooth was removal under general anesthesia. After microscopic examination, finally we diagnosis this lesion as COF. Patients of case II showed radiolucent lesion at the mandible. Lesion was enucleated under general anesthesia. After microscopic examination, finally we diagnosis this lesion as COF. The patients which we presented did not complain any specific complications, showed good prognosis.

This study aimed to compare the mandible inferior cortical bone thickness before and after orthognathic surgery on panoramic radiographs. Among 1092 orthognathic surgery patients, 37(12male, 25 female, average age 23.8 yrs± 4.4) were selected who underwent mandible inferior cortex contouring. The total mandible sides which underwent inferior cortex contouring were 62. The mandible inferior cortical bone thickness was measured below the mesial root of the first molar tooth. The mandible inferior cortical bone thickness was 3.49mm± 0.6mm before orthognathis surgery and 1.92 mm± 0.88 mm after surgery, with statistically significant difference between the two(p<.05). The mean contouring amount was 1.57 mm± 0.8 mm. Mandible inferior cortex contouring are often included in orthognathic surgery.

도토리에 구멍을 뚫고 가지를 자르는 도토리거위벌레(Cyllorhynchites ursulus, n=130)의 큰턱(mandible)의 외부형태 와 가지를 자르는 기작을 생체모방에 이용하기 위하여 분석을 하였다. 또한 큰턱의 외부형태와 자르는 기작비교를 위하여 비슷한 습성을 가진 밤바구미(Curculio sikkimensis, n=30), 왕거위벌레(Paracycnotrachelus longiceps, n=15)의 큰턱 외부형태를 분석하였다. 외부형태 분석을 위하여 각 종의 큰턱을 주사형전자현미경(SEM)으로 촬영, 도토리거위 벌레의 자르기 행동과 뚫기 행동은 영상 촬영으로 분석하였다. 도토리거위벌레는 큰턱을 좌우로 움직이며 3개의 톱니형태의 이(teeth)가 있으며, 밤바구미의 큰턱은 상하로 움직이며 2개의 톱니형태의 이가, 왕거위벌레는 좌우로 맞물리면서 씹는 움직임이며 톱니형태의 3개의 톱니형태의 이를 가지고 있다. 도토리거위벌레는 큰턱의 내·외전건 (adductor · abductor tendon)을 움직여 구멍을 뚫고 가지를 자르는 것으로 분석이 되었으며 외전건이 내전건보다 굵어 더 큰 힘이 바깥쪽으로 작용하는 것으로 분석되었다.

Odontomas are mixed odontogenic tumors in which both the epithelial and mesenchymal components have undergone functional differentiation. Two types of odonotma are histomorphologically recognized: complex and compound. Complex odontomas have little or no morphologic similarity to normal tooth formation, and they commonly found in the posterior mandible. They are typically asymptomatic, and the most common presenting symptom is usually lack of eruption of a permanent tooth. The recommended treatment for an odontoma is conservative surgical excision. No tendency for recurrence has been noted. An eight-year-old girl was presented with swollen mouth floor. Radiographically, there were radiopaque mass on anterior mandible with impacted lower left central incisor. Under midazolam intraoral sedation and N2O-O2 inhalation sedation, the odontomas were surgically removed. The diagnosis was complex odontoma. After follow-up of 28 months period, there was no recurrence. The impacted tooth erupted spontaneously and the space for the erupted tooth was regained orthodontically.

We report a rare case of intraosseous epidermoid cyst in mandibular body. A non symptomatic patient without trauma history had a cystic lesion on mandible close to the third molar. The lesion was enucleated while extracting of left lower third molar. The microscopic findings were consistent with an epidermoid cyst. Key words：Epidermoid Cyst, Intraosseous, Mandible

Peripheral ameloblastoma, a rare and unusual variant of odontogenic tumor, representing 1% of all ameloblastomas. The extraosseous location is the peculiar feature of this type of tumor, which is otherwise similar to the classical ameloblastoma. This paper describes a case of peripheral ameloblastoma in a 43-year-old female affecting the left retromolar pad area of the mandible which was clinically diagnosed as a pyogenic granuloma. Histologically, the tumor showed of follicular ameloblastoma in continuity with a surface oral epithelium.

Dentinogenic ghost cell tumor (DGCT) is a rare neoplasm, representing 1.9% to 2.1% of all odontogenic tumors. Peripheral DGCT is a rare tumor with only 25 cases previously described in the English literature. The majority of cases have been reported to occur in the anterior part of the jaws. A rare case of peripheral DGCT is reported, located in the lingual side of the anterior mandible of a 68-year-old man. The patient presented a pedunculated painless growth of 1.5cm in diameter. Radiographically, no bone involvement was found. The lesion was excised and histologically characterized by islands of epithelial cells showing ameloblastoma-like features within fibrous background tissue. Dysplasic dentin and ghost cells with calcifications were frequently observed. Areas showing a connection between tumor cells and the overlying mucosa were also identified.

Mucoepidermoid carcinoma, a malignant neoplasm of salivary gland, rarely arises within the jaws. Differential diagnosis should include an odontogenic cyst because the central mucoepidermoid carcinoma usually reveals either an unilocular or multilocular radiolucency with hyperostotic border. Long-term follow-up is needed due to late recurrence and clinical slow progress like other salivary gland tumors. We would like to report an unusual case of central mucoepidermoid carcinoma with a review of literature.

The juvenile ossifying fibroma, differentiated from the large group of ossifying fibroma based on the patient’s age, common sites, and clinical characteristics, is a rare but locally aggressive benign tumor with high recurrence rate. Herein, we report a case of juvenile ossifying fibroma located in the right mandible, which is an uncommon site. A 8-years- old male child presented to the pediatric unit of our institution with swelling on the right mandible. Radiographically, it was presented as an expanded and radiolucent lesion. Histology revelaed hypercellular fibroblastic proliferation with anastomosing osteoid trabeculae with rounded, strongly basophilic calcified mass rimmed by osteoblasts. Surgical management was done, and regular follow-up is advised

A Mixed tumor is a tumor that derives from multiple tissue types. This lesion appears to be mostly Mixed Radiolucent and Radiopaque aspect and typical examples are odontoma, ameloblastic fibroodontoma, ameloblastic fibroma etc. A odontogenic tumor is a neoplasm of the cells or tissues that initiate Odontogenic processes. Typical example is a odontoma. The odontoma is a hamartoma of odontogenic origin. There are two types: compound and complex. A compound odontoma still has the three separate dental tissues (enamel, dentin and cementum), but may present a lobulated appearance where there is no definitive demarcation of separate tissues between the individual "toothlets". It usually appears in the anterior maxilla. The complex type is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities. It usually appears in the posterior maxilla or in the mandible. We reported 20-years old male patient who had an atypical mixed radiolucent and radiopaque lesion on right mandibule body tentative diagnosed as complex odontoma and excised.

Abstract. Inflammatory myofibroblastic tumor (IMT) is considered as a benign tumor with local aggressive course, consisting of myofibroblastic spindle cells with an inflammatory cells infiltration. IMTs are more usually found in the lung and very rarely in the mandible. We report an IMT of the mandible in a 54-year-old man. The patient complained of pain on the right side of mandible. Radiographically, the lesion was occupied in the right mandible with bone destruction. Although the initial diagnosis was an osteomyelitis, the histopathologic examination and immunohistochemistry revealed it to be an IMT. Histologically, the lesion was composed of inflammatory cells infiltration within a variably fibroblastic or myofibroblastic spindle cell background. Immunohistochemically, spindle cells stained with smooth muscle actin (SMA) and CD68 (KP1), but uniformly negative with desmin and cytokeratin.

Small cell osteosarcoma of bone, which was first described in 1979, is an unusual variant of osteosarcoma. Osteoid production by tumor cells is frequently focal or minimal, making the differential diagnosis with other small round cell tumors of bone difficult. Here, we present a rare case of small cell osteosarcoma of the mandible appearing as bony bulging mass in 31-year-old male who has neither tenderness nor paresthesia. Histologically, the tumor contains hypercellular cartilage and abnormal osteoid associated with small round to ovoid malignant cells. Awareness of small cell osteosarcoma should be emphasized because it has worse prognosis than both other small round cell tumor and conventional osteosarcoma.

Abstract. The keratoameloblastoma is a benign lesion of the jaws, which is a rare histologic variant of the ameloblastoma. There is a variation in the histopathologic appearance of reported cases under the appellation of keratoameloblastoma. The keratoameloblastma has usually keratin formation by the ameloblastomatous epithelium and varies in size. English literature reports only 14 cases of keratoameloblastma. We described an additional case of the tumor developed in the right mandible of a 26-year-old woman. It was presented as an expansile and radiolucent lesion. Histologically, solid tumor islands were seen with some microcystic space within a fibrous stroma resembling an ameloblastoma. In addidion, a hyperchromatic columnar basal cell layer and parakeratin within the microcyst simulating an odontogenic keratocyst

The ossifying fibroma (OF), with the microscopic features of trabuclae or spherules of bone or cementum-like material in a cellular fibrous connective tissue stroma, is one of the most common benign fibro-osseous lesions in the jaw bones. The OF often occurs in patients from 20 to 40 years of age, which is a definite female predilection. The mandibles are involved far more often than the maxillas, especially the pre-molar and molar regions. It is slow-growing, bone producing, asymptomatic and well-demarcated. The OF is a disorder of odontogenesis or osteogenesis ascribed to bone marrow stroma cells (BMSCs) abnormality. However, the detailed mechanisms of OF’s oncogenesis, cytodifferentiation, and tumor progression remain unknown. In this article, we reported a huge central OF on the anterior mandible. The lesion was enucleated and peripheral ostectomy was done via intraoral approach and reconstructed with vascularized iliac block bone graft. After 25 months of follow up, the tumor had not recurred. This case shows that OF may be successfully treated by conservative surgical enucleation and peripheral ostectomy.

A 78 year-old male complained of mild pain at a gingival mass on his anterior mandible, injured and ulcerated by autobicycle accident six months ago. He had suffered from uncontrolled diabetes. The tumor specimens from his chin and gingiva were examined by immunohistochemical method, and their microsections showed poorly differentiated polygonal tumor cells, occasionally formed ductal structures. The tumor cells grew infiltratively into adjacent fibromuscular tissue with frequent atypical mitosis, exhibiting the features of poorly differentiated adenocarcinoma. However, in the computed tomography(CT) view a tumor mass was also found in his lung, and diagnosed lung cancer. In the immunohistochemical observation the tumor cells were strongly positive for thyroid transcription factor 1(TTF-1), cytokeratin 7, PCNA, p53, and PIM-1, occasionally positive for p63, but sparsely positive for survivin. The tumor cells were almost negative for S-100, cytokeratin 14, and α-SMA, while the vascular structures in the tumor tissue were conspicuously demarcated by the stains of α-SMA. Taken together, the present case was finally diagnosed poorly differentiated adenocarcinoma, metastasized from lung adenocarcinoma. And it was presumed that the metastatic tumor cells tended to be anchored in the traumatized area of anterior mandible, where the wound healing was undergoing with de novo angiogenesis and the activation of different cytokines and growth factors

The osteoblastic activity of carcinoma is restricted in osteoblastic metastasis, common in the patients with prostate cancer, whereas its mechanism and the factors involved are unknown. Here, we present a case of central adenocarcinoma showing the osteoblastic activity in the mandible of the 80-year-old Korean male who had suffered from the paresthesia of lower lip during four mouths. Clinically the overlying oral epithelium was intact, but the radiologic images revealed the ill-defined radiolucent intraosseous lesions in left ascending ramus. Microscopically, the mandibular lesion was composed with carcinoma of ductal or glandular differentiation but lack typical features of any epithelial salivary gland malignancies. Intriguingly abundant new bone formation was found in the stroma, but the tumor cells expressed no reactivity for prostate-specific antigen(PSA). The patient had low ionized calcium level, normal serum alkaline phosphatase and PSA level. Positron emission tomography-computed tomopraphy scan revealed the benign prostatic hyperplasia, but failed to trace the primary site of tumor other than mandible. Therefore, pathologically diagnosis for the lesion was informed as adenocarcinoma, not otherwise specified(NOS). Because occult primary tumor associated with osteoblastic metastasis cannot be completely ruled out, periodic and careful check-ups for the patient should be performed.

Central granular cell odontogenic tumor (CGCOT) is a rare benign odontogenic neoplasm, with approximately 30 cases having been reported. The pathogenesis of CGCOT as well as the designation of this lesion is controversial because of unknown histogenesis of the granular cell. We present an additional case of CGCOT involving the mandible of a 50-year-old Korean man who complained of asymptomatic swelling of the right buccal gingiva. Current lesion is microscopically characterized by densely packed polyhedral granular cells surrounding interspersed islands or strands of odontogenic epithelium. Immunohistochemically, granular cells were positive for Vimentin and CD68, and negative for cytokeratin and S-100. These features support a mesenchymal origin for the granular cells as other results previously reported.

Although the sparganosis involving soft tissues, i.e, tongue, cheek, etc., has been frequently reported, the mandibular involvement of sparganosis is not reported up to date. We present a case of intraosseous sparganosis involving whole mandible, which was clinically diagnosed as chronic osteomyelitis. After surgical operation of saucerization for the treatment of chronic osteomyelitis the removed specimens were pathologically examined and finally turned out intraosseous sparganosis. Radiological findings showed irregular multiple radiolucencies in round to ovoid shape throughout both mandibular body areas, of which peripheral rarefying radiopacity was less remarkable compared to the ordinary osteomyelitis. However, the radiolucencies of periapical granuloma, #34-36, were closely associated with the osteolytic lesions of mandibular body. Pathological examination showed a tunnel like space for the passage of sparganum larva, and heavy infiltration of eosinophilicleukocytes. And more, the parasitic tegument materials were found admixed with eggs in the granulomatous lesion, which were gradually degraded and resolved. Taken together, we presumed that the mandibular inflammatory lesion was primarily involved with sparganosis and secondarily aggravated by the periapical infection of #34-36.

Cholesterol granuloma(CG) occurs frequently in association with chronic middle ear diseases, particularly diseases in the mastoid antrum and air cells of the temporal bone, and much less frequently in paranasal sinuses. It occurs frequently secondary to massive hemorrhage of oral and paraoral cysts. However, It has never been reported to occur solely without any association with preexisting lesion in the mandible. We experienced development of unusual cholesterol granuloma in the mandible. Seventy year old female presented diffuse hard swelling on the left mandibular area with lymphadenopathy of the left cervical lymph node. Radiographic examination showed a well circumscribed multilocular radiolucency resembling soap bubble appearance with tooth displacement and root resorption, leading to the radiogrphic impression of dentigerous cyst or odontogenic cyst or ameloblastoma. CT showed bucco-lingually undulating expansile lesion with corticated margin from the left posterior mandibular body to the anterior ramus, including #46, #47 and #48, and the mass showed slightly lower attenuation than muscle. leading to the impression of ameloblastoma. The mass after surgical excision composed of 2 sac like structures, measuring 4.0cm, and 2.7cm in diameter respectively. One sac was tightly attached to the #46, resembling dentigerous cyst. Microscopic examination showed a large number of cholesterol clefts in association with hemorrhage, hemosiderin pigments and foreign body giant cells. There was no evidence of cyst or other lesions

Cholesterol granuloma(CG) occurs frequently in association with chronic middle ear diseases. pa rti cul arly dis eases in the mastoid antrum a nd ai r cells of the tempora l bone. and much less frequent ly in paranasal sinuses, It occurs f1'eq uentJy seconda1'Y to massive hemor1'hage of oral and pal'aol'aJ cysts, Howeve1'. It has nevel' been I'eported to OCCUI' solely wi thout any association of pl'eexisting lesion in the mandibJe We expel'ienced development of unusuaJ cholestel'ol granuloma in the mandible, Seventy year old female pl'e sented diffuse ha1'd swelling on the left mandibular a rea with Iymphadenopathy in the left cer vical Iymph node Radi og1'aphic exarnination showed a well circumsc ribed multi locular radiolucency resembling soap bubble appeara nce with tooth di s placement and root resorption‘ leading to the radiogrphic imp1'ession of dentigerous cyst 0 1' 。dontogenic cys t or amelobJas toma, CT showed bucco-lingua lly undul ating expansi le lesion with co rticated ma l'gin from the left posterior mandibular bocly to the anterior ramus. including #46, #47 ancl #43. and the mass containing in the lesion showed s lightly lower a ttenuation than muscJe leading to the impression of ameloblastoma, The mass aftel' surgical excis ion composed of 3 sac like structures, measuring 4,1 cm, 1, 3cm ancl 1.4cm in diame ter respectively, One sac was t ightl y a ttached to the #46. l'eRembling dentigerous cyst, Mi croscopic examination showed a large numbel' of c h이 es te rol clefts in association with hemol'rhage, hemosiderin pigments and fO l'eign body giant cells, There was no evidence of cyst 0 1' other lesions, CG should be taken into diffe l'enti a l diagnosis in addition to odontogenic cysts and tumors when radiographica lly well ci rcumscribed multilocuJal' radiolucent lesion occurs