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sdj-10159

Pathological Fractures Of The Jaws Due To Cystic Lesions: A Three Case Series With A Brief Review Of The Literature

Nicotra F.*, Rizzo R.* , Bevilacqua L.* , Costantinides F.*, Maglione M.*
 
* Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy, Piazza dell’Ospitale 1, 34129, Trieste, Italy.
 
 
 
Submitted: May 8, 2022, Accepted: October 30, 2022, Published: December 1, 2022.
 
DOI: https://doi.org/10.17656/sdj.10159

Abstract

This study aims to describe pathologic fractures of the jaws due to cystic bone lesions. Their daily clinical practice findings are not very common, so their treatment can be challenging. In addition, endosseous benign lesions like a radicular, residual, solitary, aneurysmal cyst, and odontogenic keratocyst, might weaken the bone so that trauma, or usual chewing, could break it. We follow from the first clinical examination to the X-ray or CBCT examination and surgical management of our patients, reporting all procedures and results to explain our approach to these cases. We also reviewed the literature briefly to determine if our operative management is in line with the scientific community. Mandibular angle and body are common locations, while symphysis and condyle are less so. Young men are the most affected, and trauma is the most triggering event. Cyst enucleation, followed by fracture reduction and fixation, is the treatment of choice for our clinical team and the scientific community. We observe how impactful it is to approach the cavity of the cystic lesion from the fracture line as the surgical gold standard.

                                                                                 

Keywords: Pathological fractures, cystic lesions, maxilla, mandible.        

 

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References:

1. Grether A, Vidal P, Meyer J. Paradental cyst of the mandible evolving into a fracture. Inf Dent. 1951;33(6):295-300.
2. Boffano P, Roccia F, Gallesio C, Berrone S. Pathological mandibular fractures: a review of the literature of the last two decades. Dent Traumatol 2013;29(3):185-96.
3. Chell M, Idle M, Green J. Case Report: An unusual finding of a solitary bone cyst in a patient with a fractured mandible. Dent Update. 2015;42(10):977-78.
4. Choi BJ, Choi SC, Kwon YD. Aneurysmal bone cyst causing a pathologic fracture of the mandibular condyle. J Oral Maxillofac Surg. 2011;69(12):2995-3000.
5. Gerhards F, Kuffner HD, Wagner W. Pathological fractures of the mandible. Int J Oral Maxillofac Surg. 1998;27(3):186-90.
6. Ezsias A, Sugar AW. Pathologic fractures of the mandible: a diagnostic and treatment dilemma. Br J Oral Maxillofac Surg. 1994;32(5):303-6.
7. Kalantar Motamedi MH. Aneurysmal bone cysts of the jaws: clinicopathological features, radiographic evaluation and treatment analysis of 17 cases. J Craniomaxillofac Surg. 1998;26(1):56- 62.
8. Goddard R, Patel N. Aneurysmal bone cyst masquerading as unknown mandibular metastatic deposit causing pathological fracture. Dent Update. 2007;34(4):230-2.
9. Madiraju G, Yallamraju S, Rajendran V, SrinivasaRao K. Solitary bone cyst of the mandible: a case report and brief review of literature. BMJ Case Rep. 30;2014:bcr2013200945.
10. Xiao X, Dai JW, Li Z, Zhang W. Pathological fracture of the mandible caused by radicular cyst: A case report and literature review. Medicine (Baltimore). 2018;97(50):e13529.
11. Coletti D, Ord RA. Treatment rationale for pathological fractures of the mandible: a series of 44 fractures. Int J Oral Maxillofac Surg. 2008;37(3):215-22.
12. Hs CB, Rai BD, Nair MA, Astekar MS. Simple bone cyst of mandible mimicking periapical cyst. Clin Pract. 2012;2(3):e59.
13. Velasco I, Cifuentes J, Lobos N, San Martín F. The unusual evolution of a simple bone cyst in the mandible: A case report. J Clin Exp Dent. 2012;4(2):e132-5.
14. Kramer IR, Pindborg JJ, Shear M. The WHO Histological Typing of Odontogenic Tumours. A commentary on the Second Edition. Cancer. 1992;70(12):2988-94.
15. Saito Y, Hoshina Y, Nagamine T, Nakajima T, Suzuki M, Hayashi T. Simple bone cyst. A clinical and histopathologic study of fifteen cases. Oral Surg Oral Med Oral Pathol. 1992;74(4):487-91.
16. Harnet JC, Lombardi T, Klewansky P, Rieger J, Tempe MH, Clavert JM. Solitary bone cyst of the jaws: a review of the etiopathogenic hypotheses. J Oral Maxillofac Surg. 2008;66(11):2345-8.
17. Lucas CD, Blum T. Do all cysts in the jaws originate from the dental system?. J Am Dent Assoc 1929;16(4):647-61.
18. Howe GL. Haemorrhagic cysts of the mandible. Br J Oral Surg. 1965;3(1):55-76.
19. Jabloński M. Treatment of the mandibular fractures with the course through the lumen of the odontogenic cysts. Czas Stomatol. 1967;20(4):363-8.
20. Marsden J. Fracture of the mandible due to radicular and residual odontogenic cysts. Br J Oral Surg. 1964;2(5):71-5.
21. Amos M, Dalghous A, Alkhabuli J, Mizen K. Massive maxillary radicular cyst presenting as facial fracture and abscess, a case report. Libyan J Med. 2007;2(4):211-3.
22. Baird WO, Askew PA. Traumatic mandibular bone cyst involved in line of fracture. Oral Surg Oral Mad Oral Pathol. 1958;11(12):1351-6.
23. Martensson G. Bone cysts of the mandible. Oral Surg Med Oral Pathol. 1965;19:639-54.
24. Zambito RF, Laskin DM. Follicular cyst of mandible associated with pathologic fracture: report of a case. J Oral Surg Anesth Hosp Dent Serv. 1964;22:449-52.
25. Matise JL, Beto LM, Fantasia JE, Fielding AF. Pathologic fracture of the mandible associated with simultaneous occurrence of an odontogenic keratocyst and traumatic bone cyst. J Oral Maxillofac Surg. 1987;45(1):69-71.
26. Ahlers E, Setabutr D, Garritano F, Adil E, McGinn J. Pathologic fracture of the mandible secondary to traumatic bone cyst. Craniomaxillofac Trauma Reconstr. 2013;6(3):201-204.
27. Abir B, Guerrouani A, Abouchadi A. Pathological fractures of the mandible: A report of ten cases and a review of the literature. Open J Stomatol. 2013;3(8):419-24.
28. Kouhsoltani M. Mesgarzadeh A, Moradzadeh K. Mandibular fracture associated with a dentigerous cyst: report of a case and literature review. J Dent Res Dent Clin Dent Prospects. 2015;9(3):193-8.
29. Cope, M. Spontaneous fracture of an atrophic edentulous mandible treated without fixation. Br J Oral Surg. 1982;20(1):22-30.
30. Castro-Núñez J, Cunningham LL, Van Sickels JE. Atrophic Mandible Fractures: Are bone grafts necessary? an update. J Oral Maxillofac Surg. 2017;75(11):2391-8.
31. Alagöz MS, Uysal AC, Sensoz O. An alternative method in mandibular fracture treatment: bone graft use instead of a plate. J Craniofac Surg. 2008;19(2):411-20.


 
 
 
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