Muhammad Reza Pahlevi
Oral and Maxillofacial Surgery Clinic, Dr. Kariadi Hospital, Semarang, Indonesia

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Follicular Ameloblastoma of Maxillary: A Case Report Athalaila Azzahrasukma Sakuntala; Septa Santiya Arini; Johanna Kezia Prajogo; Muhammad Reza Pahlevi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1048

Abstract

Introduction: Ameloblastoma is a benign odontogenic tumor that appears in the mandible and maxilla. Ameloblastoma has slow growth that takes several years for symptoms to appear, but ameloblastoma in the maxilla has a more aggressive clinical course compared to the mandible. The lack of initial symptoms leading to diagnosis at an advanced disease when the tumour has already extended beyond maxilla. The cancellous structure of the maxillary bone makes it easier for tumors to spread to the nasal cavity, paranasal sinuses, orbitals, parapharyngeal tissue and skull base. This article reports a case of resection of maxillary ameloblastoma. Case Report: A 63 year old female patient came with complaints of a lump on her right cheek since 2 years back that gradually increased in size. Since 2 months ago, pus and blood have been coming out of the lump. Extra oral examination revealed a well-defined mass with a solid and hard consistency, there were no ulcers or fistulas. Intraorally, a mass measuring 5x5x3cm was found in the region of teeth 12 to 15 which extended to the buccal-palatal area. History of allergies and weight loss was denied. Supporting examinations including panoramic radiography, PA chest radiography, CT-Scan, FNAB, and biopsy resulted in a diagnosis of ameloblastoma. Treatment was carried out by resection of the right maxillary tumor mass under general anesthesia. Discussion: In this case, the patient's clinical examination showed a hard and large palpable swelling in the right maxilla area which extended from the region of tooth 12 to tooth 15 which caused facial asymmetry and no tooth mobility was found. This hard and painless swelling takes about 2 years before the patient experiences symptoms of pus and blood discharge. The post-maxillectomy defect in this case was covered with an intraoral prosthesis in the form of a post-surgical obturator made of acrylic resin. The obturator functions to hold the surgical packing, and prevent food or dirt contamination in the defect area which can cause infection and slow healing. The use of a prosthesis also helps restore swallowing and speech function to the patient. Conlussion: In principle, the treatment for ameloblastoma is resection of the involved bone, as in this case the action taken is a maxillectomy. Maxillectomy can result in facial and oral cavity deformities characterised by facial disfigurement and alterations in oral functionality.Therefore, maxillary reconstruction is needed to treat maxillary defects after surgical procedures involving the loss of part or all of the maxilla.
MANAGEMENT OF ORIF IN PATIENTS WITH MAXILLOFACIAL FRACTURES Ega Iqomatul Haque; Zuyyina Maisura; Farizqa Nadila Sofiana; Muhammad Reza Pahlevi
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 15, No 5 (2026): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v15i5.55833

Abstract

Introduction: A strong enough impact can cause fractures in the facial area. The most common cause of facial bone fractures is traffic accidents in two-wheeled motor vehicles. Most jaw and facial fractures occur in young men aged 16–40 years. Case Report: A 19-year-old male patient came to Dr. Kariadi Semarang Hospital, complaining of a choking bite when opening and closing the mouth after a single traffic accident. Extraoral examination showed facial asymmetry, subconjunctival bleeding dextra sinistra, palpable step off infra orbital region dextrasinistra, maxillary dextrasinistra, frontonasalis, mandibular symphysis region, and floating palpation  of the maxilla. Intraoral examination showed a 1-finger mouth opening,  an anterior bite open, vulnus laceratum anterior mandibular region of teeth 31-41 and superimposed segments  of maxillary sinistra teeth 22-23. Open Reduction and Internal Fixation (ORIF) has  been carried out with miniplates and screws as well as the installation  of Interdental Fixation (IDW) and Intermaxillary Fixation (IMF) Discussion: The main principles of fracture management are infection control, fracture fragment reduction, fixation, and immobilization. Reductions must be made to restore function and aesthetics. The occlusion should be used as a guide, so that when occlusion is achieved, the mastication function also functions properly. ORIF is the gold standard in fracture management. Conclusion: Maxillofacial fractures can be caused by various traumas, they can occur alone or at the same time as other fractures. ORIF followed by IDW and IMF insertion may be a comprehensive treatment option in maxillofacial fractures to restore good bone occlusion, aesthetics, and fixation function.