Diffuse-type giant cell tumour (DTGCT) is a benign but destructive proliferative disorder of the synovium of joint capsules, tendons and bursae. Lesions originating from the articular synovium may grow intra-articularly or expand widely extra-articularly. Rare cases may develop only in peri-articular tissues. Temporomandibular joint (TMJ) involvement is exceptional and only two cases of purely extra-articular TMJ-DTGCT have been reported. The authors report an additional case of extra-articular TMJ-DTGCT. The clinical features, histopathological characteristics, imaging modalities and diagnostic methods for DTGCT are discussed together with a literature review based on the clinical aspects of TMJ involvement.

Implant rehabilitation in oral lichen planus (OLP) is a major challenge for clinicians and patients. There is limited scientific evidence, primarily case reports and small case series. We conducted a literature review of data on the effectiveness and safety of implant rehabilitation in OLP patients. MATERIAL AND METHODS: We searched MEDLINE, Embase and Cochrane databases for articles on implant placement in OLP patients (searches from 1980 to 2011). RESULTS: Eight studies (41 OLP patients rehabilitated with 135 implants) met the inclusion criteria. Survival rate of implants was 94.8% over a mean follow-up of 56.5 months. CONCLUSIONS: There is very limited evidence on the safety and benefits of implant placement in OLP patients. Implant loss appears not to be directly related to OLP, but linked to factors such as parafunctions, poor bone quality and marginal mandibular resection. The benefits and harms of using implants in people with OLP require thorough evaluation in properly designed randomised, controlled studies. CLINICAL RELEVANCE: OLP is not an absolute contraindication for implant insertion and there is no increased risk of failure. Implants should be positioned only if mucosal signs and symptoms are in the remission phase. A careful oral hygiene and frequent follow-up are the main recommendations in OLP patients rehabilitated with implants.

Mucinous adenocarcinoma (MAC) is a malignancy rarely affecting the salivary glands, with fewer than 30 cases described in the medical literature. MAC is mostly observed in the minor salivary glands of the palate, and to date, no case of salivary MAC has been reported in the mandible. Identifying a salivary MAC may be both clinically and histopathologically challenging, as differential diagnosis must consider not only other salivary malignancies expressing a mucinous component but also metastases from MACs of the gastrointestinal tract, breast, and sweat glands that strongly resemble a salivary MAC on histopathology. We describe an 80-year-old man with a gingival overgrowth of the left mandible for the past 9 months, who was referred to our institution with an initial diagnosis of a periodontal reaction. On clinical examination, the mass mimicked a hyperplastic lesion; but after biopsy, the histopathologic pattern suggested a diagnosis of MAC. Herein, we present how comprehensive physical examination of the patient, immunohistochemistry study of the specimen, and radiological features helped in establishing the diagnosis of intraosseous salivary MAC, ruling out metastatic disease or other salivary neoplasms.