{"title":"Evaluation of the efficacy of three distinct lip repositioning techniques and identification of the approach associated with the lowest relapse rate. A six-month follow-up case report","authors":"Mohamad A. Alhomsi, Issa B. Wehbeh","doi":"10.1016/j.omsc.2025.100423","DOIUrl":"10.1016/j.omsc.2025.100423","url":null,"abstract":"<div><h3>Background</h3><div>A beautiful smile is a key element of facial aesthetics, with an average gingival display of 1–3 mm in smile position. When gingival visibility exceeds this range, it is defined as a gummy smile. This condition may result from skeletal, dentoalveolar, or soft tissue factors.</div></div><div><h3>Case description</h3><div>Three patients with mild gummy smile were treated using different approaches: (i) traditional lip repositioning surgery, (ii) modified lip repositioning surgery, and (iii) Botox injection. Patients were monitored for two weeks to assess postoperative complications. Follow-up evaluations at two weeks, one month, three months, and six months assessed gingival exposure and relapse.</div></div><div><h3>Conclusion</h3><div>The modified lip repositioning procedure demonstrated greater stability between the three- and six-month follow-ups, with the least relapse, although it was associated with more postoperative complications. Botox was the most preferred option due to its non-invasive nature.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100423"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145057328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rehabilitation of the atrophic maxilla: Guided Le Fort I maxillary advancement and zygomatic implants with and immediate loading","authors":"Rémy Raphael , Dimitri Pascual","doi":"10.1016/j.omsc.2025.100422","DOIUrl":"10.1016/j.omsc.2025.100422","url":null,"abstract":"<div><h3>Introduction</h3><div>The full-arch rehabilitation of the atrophic maxilla using four zygomatic implants (ZI) has become a widespread solution, allowing us to bypass bone grafting procedures. However, the palatal prosthetic emergences inherent to the skeletal discrepancy cause significant discomfort for patients due to prosthetic compensations volume.</div></div><div><h3>Observation</h3><div>A 60-year-old patient, completely edentulous at the maxillary with severe atrophy and a skeletal Class III, was referred to us for full rehabilitation. We use an innovant surgical guide to perform the Le Fort I osteotomy, placement of four zygomatic implants, and immediate loading of a screw-retained Zirconia bridge without prosthetic compensation in one single surgery virtually planned.</div></div><div><h3>Conclusion</h3><div>Zygomatic implant and orthognathic rehabilitation, using a custom surgical guide, offers an accurate solution to restore in a single surgery, the oral function with an immediate loading prothesis when the maxilla atrophy is severe in skeletal Class III.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100422"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spindle cell lipoma in the pterygomandibular space: A case report","authors":"Natsumi Takamaru , Naoyuki Fukuda , Kazuya Akita , Yukihiro Nogami , Takaaki Tsunematsu , Naito Kurio","doi":"10.1016/j.omsc.2025.100420","DOIUrl":"10.1016/j.omsc.2025.100420","url":null,"abstract":"<div><div>Spindle cell lipoma (SCL) is a subtype of lipoma classified by Enzinger et al. in 1975. It is a benign tumor commonly found in the subcutaneous tissue of the shoulder, back, and posterior neck in middle-aged men. This report describes a rare case of low-fat type SCL in the pterygomandibular space. A 33-year-old man was referred to the department for further examination and treatment of a radiolucent area of the left mandibular ramus incidentally detected on a panoramic radiograph taken by a general dentist. Computed tomography and magnetic resonance imaging showed a 50 mm mass with apparent continuity with the inferior alveolar neurovascular bundle in the pterygomandibular space. An incisional biopsy prompted a provisional diagnosis of neurofibroma, and the whole tumor was excised under general anesthesia. Histopathologically, the tumor was found to consist of spindle-shaped cells, adipocytes, and collagen fibers, resulting in a final diagnosis of SCL. There has been no evidence of recurrence more than 5 years postoperatively.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100420"},"PeriodicalIF":0.0,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tariq Wahass , Khalid Almutairi , Fares Alrawashedah , Mohammed Assiri , Ali Almontashari
{"title":"Cranial base fracture associated with pneumocephalus and cerebrospinal fluid leakage following surgically-assisted rapid maxillary expansion: A case report","authors":"Tariq Wahass , Khalid Almutairi , Fares Alrawashedah , Mohammed Assiri , Ali Almontashari","doi":"10.1016/j.omsc.2025.100418","DOIUrl":"10.1016/j.omsc.2025.100418","url":null,"abstract":"<div><div>Surgically assisted rapid palatal expansion (SARPE) is generally safe, with rare major complications. We report a unique case of a 22-year-old woman with a history of meningomyelocele who developed pneumocephalus and cerebrospinal fluid (CSF) rhinorrhea six days after SARPE with pterygomaxillary disjunction. Imaging revealed a skull base fracture at the roof of the right sphenoid sinus and bilateral ossified pterygospinous ligaments, which may have redirected osteotomy forces to the cranial base. The patient presented with positional headaches and clear nasal discharge, and CSF leakage was confirmed by MRI. She was successfully managed with conservative treatment, including bed rest, head elevation, and antibiotics. This case highlights the importance of recognizing anatomical variations that may predispose patients to skull base injury during SARPE and stresses the need for prompt evaluation of symptoms like rhinorrhea and headache. Early diagnosis and non-surgical management can lead to favorable outcomes, even in the presence of complex skull base fractures.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 4","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alamira haya Salloum , Nayar Khadro , Iyad Ali , Mounzer Assad , Zuheir Alshehabi
{"title":"The trinity of chronic kidney failure, hyperparathyroidism, and brown tumors: a case report","authors":"Alamira haya Salloum , Nayar Khadro , Iyad Ali , Mounzer Assad , Zuheir Alshehabi","doi":"10.1016/j.omsc.2025.100417","DOIUrl":"10.1016/j.omsc.2025.100417","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is an irreversible progressive glomerular disease, and it can cause many complications like osteodystrophy, hyperparathyroidism (HPT), or bone lesions such as Brown Tumors (BT)</div><div>BTs are rare slow-growing lesions in skeletal and facial bones and are benign.</div><div>This paper describes a patient with tertiary hyperparathyroidism (THPT) and CKD-MBD who developed a large maxillary BT.</div></div><div><h3>Case presentation</h3><div>A 28-year-old male presented with swelling in the maxillary bone caused by secondary hyperparathyroidism (SHPT) after 14 years of chronic kidney disease (CKD). Radiological examinations confirmed the presence of a bone lesion localized to the maxillary bone, indicating a tumor, followed by histological tests confirmed the tumor was a brown tumor and the role of CKD and SHPT hypothesis involvement. The tumor was treated surgically after controlling the other underlying conditions.</div></div><div><h3>Discussion</h3><div>The impaired kidney function in Chronic kidney disease (CKD) leads to vitamin D deficiency and abnormal calcium and phosphorus levels, which stimulate the parathyroid glands to overproduce parathyroid hormone (PTH), and alteration in bone resorption and formation leading to bone lesions like BTs.</div><div>The diagnosis of brown Tumors is quite challenging and usually requires a combination of clinical and laboratory examination with imaging.</div><div>The cornerstone in treating BTs is managing the underlying HPT, which may involve medication, surgery, or both.</div></div><div><h3>Conclusion</h3><div>Brown Tumors are a late complication of hyperparathyroidism and chronic kidney disease. A thorough medical history is essential for early diagnosis and appropriate treatment of BTs.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The interplay of soft tissue and osseous structures in bifid mandibular condyle: Implications for diagnosis and treatment. Case series and literature review","authors":"Gustavo Andres Grimaldi Finol , Alaa Abdulsattar Kadhim Al-Taie , Renan Elsadig Ibrahem Aadam , Ismail Farag , Abdul-Aziz ALaqeeli","doi":"10.1016/j.omsc.2025.100415","DOIUrl":"10.1016/j.omsc.2025.100415","url":null,"abstract":"<div><div>Bifid mandibular condyle (BMC) is a rare developmental or acquired anomaly of the temporomandibular joint (TMJ), characterized by the presence of a duplicated condylar head. Although often asymptomatic and discovered incidentally on imaging, BMC can be associated with TMJ dysfunction, facial asymmetry, and a history of trauma or developmental disturbances. The clinical significance of BMC remains poorly understood, with controversies surrounding its etiology, classification, and management. This article presents a comprehensive literature review on the current understanding of BMC, supported by the presentation of a unique clinical case involving a symptomatic patient diagnosed through advanced imaging modalities. The diagnostic process, clinical presentation, and treatment approach are detailed to highlight the role of thorough evaluation and multidisciplinary management. Our findings suggest that while conservative management remains the mainstay in asymptomatic cases, individualized approaches are essential when functional disturbances are present. Further studies are warranted to clarify long-term outcomes and to standardize diagnostic and therapeutic protocols for BMC within maxillofacial practice.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluation of the effectiveness of anterior segmental maxillary osteotomy in management of anterior vertical maxillary excess associated with gummy smile: A clinical study","authors":"Mohammad Kouja, Abdul Karim Khalil","doi":"10.1016/j.omsc.2025.100414","DOIUrl":"10.1016/j.omsc.2025.100414","url":null,"abstract":"<div><div>To evaluate the effectiveness of anterior segmental maxillary osteotomy in improving The amount of gingival exposure (above incisors and above canines) and the measurement of the nasolabial angle and increasing patient satisfaction in cases of excessive vertical growth of the upper jaw associated with a gummy smile.</div></div><div><h3>Materials and methods</h3><div>10 female patients, aged 20–34 years, were diagnosed with anterior vertical maxillary excess combined with a gummy smile. They underwent anterior segmental maxillary osteotomy using digital three-dimensional planning. Gingival exposure above the incisors and canines and the nasolabial angle were measured. Patient satisfaction was assessed using a numerical scale from 1 to 5 six months post-surgery.</div></div><div><h3>Results</h3><div>The findings demonstrated a statistically significant reduction in gingival exposure (from 7.00 mm to 1.20 mm above incisors, with an 97.14 % improvement) and (from 6.30 mm to 1.40 mm, with a 93.65 % improvement).And nasolabial angle(from 84.24° to 98.77° with 92.20 %).The average patient satisfaction score was 4.70 out of 5, with a low standard deviation (0.48), indicating a high level of satisfaction consistency among the patients.</div></div><div><h3>Conclusion</h3><div>Anterior segmental maxillary osteotomy is an effective and safe technique for improving gingival exposure over the maxillary incisors and canines, optimizing the nasolabial angle, and enhancing patient satisfaction in cases of excessive vertical maxillary growth associated with a gummy smile, particularly when performed with digital planning.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Braden S. Bybee , Robert S. Julian , Brian M. Woo , Adnan Mubasher
{"title":"Desmoplastic melanoma of the lower lip: A case report in an 82-year-old male","authors":"Braden S. Bybee , Robert S. Julian , Brian M. Woo , Adnan Mubasher","doi":"10.1016/j.omsc.2025.100413","DOIUrl":"10.1016/j.omsc.2025.100413","url":null,"abstract":"<div><div>This case report details the diagnosis and management of desmoplastic melanoma (DM) in an 82-year-old male presenting lower lip mass. DM is a rare, aggressive form of melanoma characterized by spindle-shaped cells within a dense fibrous stroma, often making diagnosis challenging due to its amelanotic and indurated nature. The patient presented with a 2cm × 2cm mass. After biopsy, the lesion was confirmed as DM with a Breslow thickness of 5.1mm, indicating advanced disease.</div><div>The patient underwent wide local excision with reconstructive surgery, partial parotidectomy, and selective neck dissection. Postoperatively, the lesion was re-excised to achieve negative margins. Immunotherapy with Pembrolizumab was initiated due to the stage IIB classification. The patient declined adjuvant radiation therapy but has shown no signs of recurrence on a follow-up PET scan nine months later.</div><div>This case highlights the diagnostic challenges of DM, especially on the lip, and underscores the importance of early biopsy in atypical lesions. Achieving clear surgical margins is crucial for improving outcomes, as local recurrence is a significant concern. Intraoperatively, frozen sections are not routinely performed on desmoplastic melanoma due to lack of diagnostic value and high rate of false negative. Permanent H&E sections with indicated staining can take 1–3 days to obtain results. The multidisciplinary approach, involving surgery, oncology, and radiation therapy, remains essential for optimal patient management. Although the role of adjuvant therapies is still debated, this case contributes to growing evidence suggesting the benefit of adjuvant treatments in reducing local recurrence and improving prognosis.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hassan El-Awour , Kinda Allaham , Mohammed Inam Ullah Khan
{"title":"Angina bullosa hemorrhagica: A case report and review of the literature","authors":"Hassan El-Awour , Kinda Allaham , Mohammed Inam Ullah Khan","doi":"10.1016/j.omsc.2025.100412","DOIUrl":"10.1016/j.omsc.2025.100412","url":null,"abstract":"<div><div>Here we present a case of Angina Bullosa Hemorrhagica (ABH) and review the literature highlighting its features, differentiation diagnosis from similar lesions, management considerations, and treatment options. Furthermore, we present a treatment algorithm for managing cases of this rare disorder. ABH lesions commonly manifest on the palate, tongue, buccal mucosa, lips, the floor of the mouth, and uvula. ABH range in size, from 4 to 30 mm in diameter. ABH lesions are generally self-limiting and resolve within a few days without scarring. Management recommendations may include supportive therapy for small lesions, incision for large bulla and continued palliative therapy using mouthrinses and analgesics. Though, ABH is a rare disorder, general dental practitioners ought to be aware of it. This report provides guidance on diagnosis, management and investigations in hopes to avoid ill-informed or unnecessary treatments.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tumor Transformation: Case of conversion of Ossifying Fibroma to Osteosarcoma post-excision in a young male","authors":"Sagar Rane, Nitin Bhola, Chetan Gupta","doi":"10.1016/j.omsc.2025.100409","DOIUrl":"10.1016/j.omsc.2025.100409","url":null,"abstract":"<div><div>Ossifying fibroma (OF) is a benign fibro-osseous tumor characterized by slow growth and a low recurrence risk, primarily affecting the mandible in young females. Although OF is typically non-invasive, rare cases demonstrate locally aggressive behavior, requiring surgical resection. Post-surgical transformation of into osteosarcoma, a rare malignancy with a prevalence of 0.7 per million in the jaw, is exceptionally uncommon. This report presents a rare case of a 28-year-old male initially diagnosed with ossifying fibroma, managed surgically through excision and reconstruction with an iliac crest graft. Despite achieving negative margins, the lesion underwent malignant transformation into fibroblastic osteosarcoma within a month, presenting diagnostic and therapeutic challenges.</div><div>The malignant transformation was confirmed through histopathological and immunohistochemical evaluations, revealing a high Ki-67 labeling index (60 %), indicative of aggressive tumor behavior. Following multidisciplinary tumor board discussions, the patient underwent extensive surgical management, including composite resection, segmental mandibulectomy, neck dissection, and microvascular reconstruction with a free fibula osteocutaneous flap. Despite its rarity, this case highlights the need for vigilant follow-up and comprehensive diagnostic workups for recurrent or progressive lesions post-OF resection.</div><div>This report contributes to the limited literature on malignant transformation in fibro-osseous lesions, emphasizing the importance of differentiating benign conditions from low-grade malignancies and discussing the role of surgical intervention in such transformations. Further research is required to elucidate the mechanisms of transformation, optimize management strategies, and improve outcomes for patients with similar rare pathologies.</div></div>","PeriodicalId":38030,"journal":{"name":"Oral and Maxillofacial Surgery Cases","volume":"11 3","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}