UNASSIGNED: Alveolar oral exostosis is a common, benign condition routinely found in dentistry. Clinical problems associated with exostoses are the maintenance of oral hygiene as well as the fabrication of prosthodontic appliances. Over time, exostoses may contribute to irritation and periodontal disease.
UNASSIGNED: The patient in this case study had a recurrence of exostoses and was bothered by consistent and prominent pain. She reported being a bruxer; her bruxism was exacerbated due to attention-deficit hyperactivity disorder and antidepressant medications.
UNASSIGNED: The etiology behind the recurrence of exostosis is discussed. The most evident etiology seems to be persistence of medication-induced bruxism, specifically awake bruxism.
UNASSIGNED: It is necessary to take a proper history to identify the cause of the recurrence of exostosis. Dental hygienists can contribute to a better understanding of and provide better treatment options for patients who have medication-induced bruxism.
UNASSIGNED: L’exostose buccale alvéolaire est une affection bénigne courante couramment observée en dentisterie. Les problèmes cliniques associés aux exostoses sont le maintien de l’hygiène buccale ainsi que la fabrication d’appareils prosthodontiques. Avec le temps, les exostoses peuvent causer de l’irritation et des maladies parodontales.
UNASSIGNED: Dans cette étude de cas, la patiente présente des exostoses récurrentes et est dérangée par une douleur constante et proéminente. Elle a déclaré souffrir de bruxisme exacerbé par la prise de médicaments antidépresseurs et contre le trouble déficitaire de l’attention avec hyperactivité.
UNASSIGNED: L’étiologie derrière la récurrence de l’exostose est abordée. L’étiologie la plus évidente semble être la persistance du bruxisme induit par les médicaments, en particulier le bruxisme diurne.
UNASSIGNED: Il est nécessaire d’obtenir les antécédents médicaux appropriés pour identifier la cause de la récurrence de l’exostose. Les hygiénistes dentaires peuvent contribuer à une meilleure compréhension et offrir de meilleures options de traitement aux patients atteints de bruxisme induit par les médicaments.

Benign and malignant cartilaginous bone tumors of the hand are rare findings, however representing a particular pathology due to the capacity to induce significant functional impairment. Even though a large proportion of tumors of the hand and wrist are benign, these may present destructive characteristics, deforming adjacent structures until compromising function. The most appropriate surgical approach for most benign tumors is intralesional lesion resection. Malignant tumors often require wide excision, up to segment amputation to obtain tumor control. A five-year retrospective study was performed on patients admitted in our Clinic with benign cartilaginous tumors of the hand, in which 15 patients were admitted within this period, 10 presenting with enchondroma, four presenting with osteochondroma, and lastly one with chondromatosis. After clinical and imaging evaluation, all the aforementioned tumors were surgically removed. Definitive diagnosis for all bone tumors, either benign or malignant, was established by tissue biopsy and histopathological examination, dictating therapeutic strategy.

UNASSIGNED: This study aims to introduce a reconstruction method of applying allografts and absorbable screws to repair large bone defects caused by the resection of giant osteochondroma.
UNASSIGNED: A retrospective study of a series of patients who underwent the resection of giant osteochondroma reconstructed by allografts and absorbable screws was conducted from February 2020 to September 2021. Their demographic data, location site, area of bone defect, and pertinent operative details were recorded. The reconstruction modality of allografts was elaborated on. In the follow-up, radiographic images were utilized to determine bone union, and the Musculoskeletal Tumor Society score was used to evaluate postoperative limb function.
UNASSIGNED: A total of seven patients were included, including three males and four females with an average age of 16.6 ± 6.5 years. Among them, three cases of tumors occurred in the humerus and four cases occurred in the femur. The average follow-up time was 11.3 ± 3.0 months. The average area of bone defect was 25.9 ± 8.3 cm2. No complications such as infection, nonunion, and allograft bone fracture were found during the follow-up period. Six months after the operation, the average Musculoskeletal Tumor Society score was 26.4 ± 1.6, with acceptable postoperative function.
UNASSIGNED: The cooperative application of absorbable screw fixation and allografts including mixed cortical bone and cancellous bone, which yielded satisfactory functional outcomes and acceptable postoperative complications, is an effective reconstruction method for a massive bone defect after the resection of giant osteochondroma.

BACKGROUND: Spinal osteochondroma (or exostosis) is a rare benign tumour whose clinical manifestations are delayed due to their slow growth and location. Few studies have addressed the characteristics and the diagnostic and therapeutic peculiarities of spinal osteochondroma in children. The objective of this multicentre observational study was to assess the outcomes of a cohort of children after surgery for spinal osteochondroma.
OBJECTIVE: Surgical excision of spinal osteochondroma in children is not followed by complications or recurrences.
METHODS: We included consecutive children who had surgery between 2010 and 2018 at any of eight participating centres to remove spinal osteochondromas. The cause, clinical manifestations, and location of the lesions were collected. The surgical outcomes were evaluated after at least 2 years\' follow-up.
RESULTS: We identified 22 patients who had surgery to remove 26 spinal osteochondromas at a mean age of 12.8±2.6 years. Among them, 7 had a solitary osteochondroma (SO group) and 15 had hereditary multiple osteochondromas (HMO group). At diagnosis, 72% of patients had clinical signs (spinal pain, n=4; one or more lumps, n=5; and neurological manifestations, n=3). In the HMO group, the diagnosis was made during routine MRI screening for tumours involving the spinal canal. Most osteochondromas involved the cervical spine (n=13), with no difference between the two groups (p=0.9). The lamina was the most common location but 54% of the tumours were growing within the canal (92% in the HMO group). After a mean follow-up of 5.2±4.4 years, no patients had experienced any recurrences or complications related to the disease or treatment.
CONCLUSIONS: Surgical excision of spinal osteochondromas in children is effective, with no medium-term recurrences. Our results also confirm the low peri-operative morbidity, even when the canal is involved, and the absence of any effect at last follow-up on spinal alignment. All patients with neurological manifestations at diagnosis made a full recovery.
METHODS: IV, retrospective observational cohort study.

Benign bone tumors are common incidental findings in the pediatric population during radiographic evaluation. Counseling these patients requires reassurance and raises questions about the natural history of these tumors over time. The purpose of this study was to estimate the prevalence and observe the behavior of benign childhood bone tumors in an asymptomatic population.
A historical, longitudinal radiographic collection of healthy children was reviewed, which included comprehensive left-sided radiographs of the extremities at yearly intervals. In this study, 262 subjects with 25,555 radiographs were screened for benign bone tumors at a median age of 8 years (range, 0 to 18 years). All potential tumors were reviewed by a multidisciplinary panel, which confirmed the radiographic diagnosis of each lesion, the age at which the lesion first appeared, and the age at which it had resolved. Prevalence rates were calculated using the number of distinct subjects available for each radiographic location and age.
Thirty-five tumors were identified in 33 subjects, including 19 nonossifying fibromas, 8 enostoses, 6 osteochondromas, and 2 enchondromas. The prevalence rate for all tumors combined increased with age and was 18.9% overall. The overall prevalence rates for specific tumor types were 7.5% for nonossifying fibromas, 5.2% for enostoses, 4.5% for osteochondromas, and 1.8% for enchondromas. Nonossifying fibromas demonstrated a bimodal distribution of prevalence, with a peak at 5 years (10.8%) and another after skeletal maturity (13.3%). The median age at the first appearance for all tumors combined was 9 years (range, 2 to 15 years), but varied by tumor type. Nonossifying fibromas often resolved (7 [37%] of 19), with further resolution possible beyond the last available radiograph. Enostoses, osteochondromas, and enchondromas persisted until the last available radiographs in all subjects.
The prevalence of benign childhood bone tumors of the extremities was 18.9% in a historical asymptomatic population. Longitudinal radiographs allowed observation of the timing of the first appearance and the potential for resolution for each tumor type. These findings provide unique evidence to answer many commonly encountered questions when counseling patients and their families on benign bone tumors.
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Osteochondroma is the most common bone tumour, which appears most commonly in the long bones. However, cases have been described in the scaphoid, capitate, lunate, trapezium, and trapezoid bones, which can be a cause of pain in the hand and wrist. Osteochondromas can occur concomitantly with other traumatic or degenerative processes or generate complications in adjacent structures. Below we present an osteochondroma in the pisiform bone associated with pisotriquetral osteoarthritis.

In this article, we report a case of isolated podal osteochondroma from the prehistoric Hypogeum of Calaforno (Giarratana, Ragusa, Sicily). Although the phalanx exhibiting the benign tumoral mass comes from a context featuring several commingled remains, the very good state of preservation of this bone allowed us to perform a comprehensive study of the neoplasm by applying a multidisciplinary approach encompassing archeology, morphology, stereomicroscopy, and radiology. The results from this very ancient specimen have been assessed in the light of the available paleopathological literature and clinical implications currently encountered in modern patients.

Both mandibular condylar hyperplasia and condylar osteochondroma can lead to maxillofacial skeletal asymmetry and malocclusion, although they exhibit different biological behavior. This study attempted to compare the histological features of mandibular condylar hyperplasia and condylar osteochondroma using hematoxylin-and-eosin (H&E) staining, and immunohistochemistry staining of PCNA and EXT1 with quantitative analysis method.
The H&E staining showed that condylar hyperplasia and condylar osteochondroma could be divided into four histological types and exhibited features of different endochondral ossification stages. There was evidence of a thicker cartilage cap in condylar osteochondroma as compared condylar hyperplasia (P = 0.018). The percentage of bone formation in condylar osteochondroma was larger than was found in condylar hyperplasia (P = 0.04). Immunohistochemical staining showed that PCNA was mainly located in the undifferentiated mesenchymal layer and the hypertrophic cartilage layer, and there were more PCNA positive cells in the condylar osteochondroma (P = 0.007). EXT1 was mainly expressed in the cartilage layer, and there was also a higher positive rate of EXT1 in condylar osteochondroma (P = 0.0366). The thicker cartilage cap, higher bone formation rate and higher PCNA positive rate indicated a higher rate of proliferative activity in condylar osteochondroma. The more significant positive rate of EXT1 in condylar osteochondroma implied differential biological characteristic as compared to condylar hyperplasia.
These features might be useful in histopathologically distinguishing condylar hyperplasia and osteochondroma.

BACKGROUND: Reverse shoulder arthroplasty (RSA) in complex shoulder fractures is ever more frequently. This study compares clinical and radiologic results of patients with comminuted proximal humeral fractures (PHFs) treated with RSA, with and without tuberosities grafting.
METHODS: Between January 2009 and June 2014, 55 patients aged ≥65 years with 3- and 4-part PHFs were treated surgically. Patients\' files and the hospital\'s digital database were reviewed retrospectively with at least 5-year of follow up. We constituted three groups according to the tuberosity consolidation: patients in whom the tuberosities showed anatomic consolidation (Group I) and patients either with secondary displacement of the tuberosities (Group II) or without tuberosity repair (Group III).
RESULTS: The 74% of the repaired tuberosities consolidated in anatomic position. Among range of motion (ROM), we reported that forward elevation, abduction and external rotation were significantly better in Group I than those in Group II-III. Furthermore, quick Dash score and Constant score showed more satisfied results in Group I. Regarding complications, not infection or instability were found in group I. On the other hand, in group II, we reported one patient with deep infection, leading to two steps surgery. In group III, we recorded two patients with instability required implant revision and one with deep infection treated by revision.
CONCLUSIONS: RSA showed satisfied results even at 5 year follow up. Preservation of the tuberosities in anatomic position improves active forward elevation and external rotation as well as patient satisfaction with less complications.

OBJECTIVE: To investigate the morphological features of hemimandibular hyperplasia (HH) in comparison to other condylar hyperplasia-associated asymmetries, including hemimandibular elongation (HE), solitary condylar hyperplasia (SCH), simple mandibular asymmetry (SMA) and condylar osteoma or osteochondroma (COS).
METHODS: A total of 31 HH, 9 HE, 6 SCH, 10 SMA and 10 COS patients were included in this study. Clinical documentation, panoramic radiography and computed tomography data were retrospectively reviewed. The three-dimensional measurements were performed on multi-planar reformation images and volume rendering images. The accuracy of the subjective radiological signs was evaluated using sensitivity, specificity and receiver operating curve analysis. Discriminant analysis was performed to generate predictive formulas using quantitative data.
RESULTS: The condyles in HH were regularly or irregularly enlarged, with significantly enlarged anterior-posterior length [16.2/5.29 (mean/SD, mm) P < 0.001] and volume [5.3/2.9(mean/SD, cm3) P < 0.001] compared to the normal values. The condyles in HE and SMA were normally shaped, and the quantitative measurements were within the normal range. The ramus heights in the HH patients [55.7/5.4(mean/SD, mm)] were enlarged in comparison to the contralateral side (P < 0.001) and normal values (P < 0.001). The ramus heights in the HE [52.4/7.1 (mean/SD, mm), P < 0.001] and SMA [50.3/5.0(mean/SD, mm), P = 0.002] patients were enlarged in the contralateral side comparison but were within the normal range. The mandibular body heights in HH were enlarged in the premolar [16.6/1.3 (mean/SD, mm), P < 0.001] and molar [24.8/1.4 (mean/SD, mm), P < 0.001] regions. The inferior convexity of the lower mandibular border and inferiorly displaced mandibular canal produced high specificity, sensitivity and area under the curve for the diagnosis of HH. Discriminant analysis could predict the diagnoses with a cross-validation accuracy rate of 85.7%.
CONCLUSIONS: HH is a distinct clinical entity characterized by enlargement of the condyle, ramus and mandibular body. The inferior convexity of the lower mandibular border and inferiorly displaced mandibular canal is accurate and specific for the diagnosis of HH. The condyles in HE are not hyperplastic. The term \"condylar hyperplasia\" alone cannot be used to refer to HH or HE.