The Maxillofacial Center for Diagnostics & Research

This Page: Text and Commentary on Abstracts of Miscellaneous Topics    

Miscellaneous Abstracts

Intraosseous salivary tissue: examples of embryonic rests, inflammatory entrapment and mature glands in 14 human jaws. J.Bouquot, D.Gnepp, J.Hietanen. The Maxillofacial Center, Morgantown, West Virginia, Brown University, Providence, Rhode Island and University of Helsinki, Helsinki, Finland.

Presented to the annual meeting of the American Academy of Oral & Maxillofacial Pathology in Hawaii, 1999.

Problem: Hundreds of salivary neoplasms have been found to be completely enclosed within the marrow spaces of the maxilla and mandible, yet non-neoplastic salivary tissue has never been convincingly identified within marrow, either separately or adjacent to such neoplasms. This situation has forced the acceptance of an inherently illogical odontogenic origin for intramedullary salivary carcinomas and adenomas. Objective: To microscopically evaluate a large number of maxillofacial marrow samples for the presence of intramedullary salivary tissue. Study design: 5,034 maxillofacial bone samples from the Latvala Inflammatory Bone Registry were microscopically reviewed for evidence of ectopic salivary inclusions within the marrow tissues. Contributing surgeons were contacted for each identified case of intraosseous salivary tissue in order to assure that all submitted tissue was removed from within the marrow spaces rather than overlying soft tissue. Results: 3 of every 1,000 marrow samples contained embryonic rests of salivary epithelium (n=9) or relatively mature salivary glands (n=5). Two of the mature glands appear to have been embedded or implanted into marrow through inflammatory perforations of overlying cortex in persons with chronic sinusitis. We also report the chance finding of incipient odontogenic epithelial neoplasms (n = 6) and odontogenic epithelial rests (n = 84) within the fatty marrow and outside the periodontal ligament spaces, confirming that not all odontogenic neoplasms are necessarily of periodontal ligament origin. Conclusion: Salivary rests and glands are present in no fewer than 3/1,000 maxillofacial marrow samples. This provides an additional and quite logical histogenetic explanation for the presence of intraosseous salivary neoplasms.