Report of Cases

Case 1

A 27-year old man visited the Department of Oral and Maxillofacial Surgery, Dentistry Faculty of Ataturk University on February 20, 2001 seeking treatment for a slowly enlarging mass beneath the inferior border of the body of the right mandible, anterior to the angle (Figure 1).

Figure 1.  Enlarged mass beneath the inferior border of the body of the mandible.		Figure 2.  A well-circumscribed, dense radiopacity at the inferior lateral aspect of the right mandibular angle.

There was a previous history of trauma to this area that occurred four years ago.  The patient’s mandible was fractured when he was 23 years old.  This fracture had been treated at another clinic.  The patient had an obvious right facial asymmetric swelling.  There was a 1.5 by 2 cm immobile mass on the right side of the mandible.  No other neck masses were felt. Intraoral, nasophryngeal, and laryngeal examination findings were within normal limits.  There were no features of Gardner’s syndrome.  All laboratory and data were within normal limits.  Mandibular and panoramic radiographs were obtained.  The lesion appeared as a well-circumscribed, dense radiopacity at the inferior lateral aspect of the right mandibular angle (Figure 2).

The patient was subsequently admitted to the hospital for excision of the mass.  Following induction of general nasotracheal anesthesia, a 3 cm submandibular incision was made approximately 5 cm below the inferior border of the mandible.  The soft tissue overlaying the mass was reflected and the lesion was exposed.  The mass was spherical in shape and attached to the angle (Figure 3).

Figure 3.  Surgical removal of the bony mass.	Figure 4.  Photomicrograph of the lesion.

The lesion was completely excised using a bone bur, chisel, and surgical mallet.  The cortical plate of the mandible was shaped and smoothed with the bur before wound closure.  The patient did well postoperatively. Microscopically, the material was composed chiefly of dense lamellar cortical bone (Figure 4).  A diagnosis of peripheral osteoma was made.

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Citation Number: Vol. 4, No. 3, Page 100