Abstract
Eosinophilic granuloma is thought to be a type of histiocitosis together with Hand-Schiiller-Christian and Letterer-Siwe disease. The oral lesion is relatively rare, but cases of its occurring in the mandible and soft tissues arc reported.
The outline of our case is as follows: An 18-year-old male visited the dental office because of teeth mobility associated with pain in a left mandibular molar. The patient was treated with antibiotics for several days but symptoms continued, and was referred to the Gunma University Medical School on Feb. 25, 1980 for further treatment.
The patient's general health was satisfactory. Oral manifestations revealed swelling of the check and mandibular arca, as well as gingival swelling with mobility of the 1st and 2nd premolar and 1st molar. Roentgenogram suggested ameloblastoma of the mandible but biopsy results showed it to be a bony eosinophilic granuloma. Full body radiograms were examined but indicated no abnormalities; so a diagnosis of solitary eosinophilic granuloma was made.
The patient was prevented to conic to the hospital because of a fractured fibla. During this delay the radiolucent defect in the mandible enlarged to involve the left coronoid and condylar process, and extended to the right mandibular canine.
Hemimandiblectomy was followed by an immediate reconstruction of the mandible using a Bowerman-Conroy titanium implant on Oct. 28, 1980.
The lesion was too extensive to preserve the mandible. During the operation the body and ramus section of the implant were fixed together for shaping the left side of the jaw bone. This implant was fixed to the mandible utilizing two nuts and sleeved bolts, and the condylar portion was spaced 1 cm. from the articular fossa.
Three and a half years after the operation the prognosis is favorable, and the patient is pleased esthetically, and also satisfied with his mandibular movement and his ability to masticate.
