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Gonzalez-Perez LM, Montes-Carmona JF, Torres-Carranza E, Infante-Cossio P. Total Joint Replacement for Immediate Reconstruction following Ablative Surgery for Primary Tumors of the Temporo-Mandibular Joint. J Pers Med 2023; 13:1021. [PMID: 37511634 PMCID: PMC10381122 DOI: 10.3390/jpm13071021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023] Open
Abstract
Temporomandibular joint (TMJ) tumors are rare and difficult to diagnose. The purpose of this retrospective study was to evaluate the clinicopathologic characteristics of twenty-one patients with primary TMJ tumors between 2010 and 2019 and to analyze the surgical outcome and morbidity after ablative surgery and TMJ replacement. This case series confirmed the difficulty of diagnosis and reaffirmed the need for early recognition and management of TMJ tumors. There were no pathognomonic findings associated with TMJ tumors, although single or multiple radiopaque or radiolucent areas were observed on plain or panoramic radiographs. Occasionally, bone resorption or mottled densities caused by pathologic calcification and ossification were seen. Computed tomography and magnetic resonance imaging played an important role in the diagnosis. In our study, the distribution of histologic types of TMJ tumors was quite different from that of other joint tumors. The recommended treatment was surgical intervention by ablation of the joint and TMJ replacement. The results of this retrospective study support the surgical exeresis and replacement with TMJ stock and custom-made prostheses and show that the approach is efficacious and safe, reduces pain and improves mandibular movements, with few complications.
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Affiliation(s)
- Luis-Miguel Gonzalez-Perez
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, 41013 Seville, Spain
- Department of Surgery, School of Medicine, University of Seville, 41009 Seville, Spain
| | | | - Eusebio Torres-Carranza
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, 41013 Seville, Spain
| | - Pedro Infante-Cossio
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, 41013 Seville, Spain
- Department of Surgery, School of Medicine, University of Seville, 41009 Seville, Spain
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Xia L, Jiang W, Yao K, Wei S, Yu W, Lu X. Evaluation of treatment with unilateral mandibular sagittal split ramus osteotomy and maxillary osteotomy in patients with condylar osteochondroma and mandibular asymmetry: A retrospective case series. J Craniomaxillofac Surg 2023; 51:123-129. [PMID: 36803856 DOI: 10.1016/j.jcms.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 01/20/2023] [Indexed: 01/22/2023] Open
Abstract
The aim of the study was to describe an approach where condylar resection with condylar neck preservation was combined with Le Fort I osteotomy and unilateral mandibular sagittal split ramus osteotomy (SSRO). Patients with a unilateral condylar osteochondroma combined with dentofacial deformity and facial asymmetry who underwent surgery between January 2020 and December 2020 were enrolled. The operation included condylar resection, Le Fort I osteotomy and contralateral mandibular sagittal split ramus osteotomy (SSRO). Simplant Pro 11.04 software was used to reconstruct and measure the preoperative and postoperative craniomaxillofacial CT images. The deviation and rotation of the mandible, change in the occlusal plane, position of the "new condyle" and facial symmetry were compared and evaluated during follow-up. Three patients were included in the present study. The patients were followed up for 9.6 months on average (range, 8-12). Immediate postoperative CT images showed that the mandible deviation and rotation and occlusion plane canting decreased significantly postoperatively; facial symmetry was improved but still compromised. During the follow-up, the mandible gradually rotated to the affected side, the position of the "new condyle" moved further inside toward the fossa, and both the mandible rotation and facial symmetry were more significantly improved. Within the limitations of the study it seems that for some patients a combination of condylectomy with condylar neck preservation and unilateral mandibular SSRO can be effective in achieving facial symmetry.
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Affiliation(s)
- Liang Xia
- Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, PR China.
| | - Wenxin Jiang
- Department of Stomatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Kan Yao
- Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, PR China.
| | - Silong Wei
- Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, PR China.
| | - Wenwen Yu
- Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, PR China.
| | - Xiaofeng Lu
- Department of ENT and Oral Maxillofacial Surgery, Shanghai Children Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Surgical Guides and Prebent Titanium Improve the Planning for the Treatment of Dentofacial Deformities Secondary to Condylar Osteochondroma. J Craniofac Surg 2021; 33:1488-1492. [PMID: 34873102 DOI: 10.1097/scs.0000000000008394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To investigate current Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) technologies applied in the treatment of dentofacial deformities secondary to condylar osteochondroma and introduce a modified method with additional pre-bent titanium miniplates to improve the accuracy of operation. METHODS Literature review about the application of CAD/CAM in the treatment of condylar osteochondroma and secondary dentofacial deformities was conducted. And 8 patients with condylar osteochondroma and secondary dentofacial deformities were treated by the CAD/CAM cutting and drilling surgical guides as well as pre-bent titanium miniplates. Pre- and post-operative 3D-cephalometric measurement were recorded and the difference between virtual simulation and postoperative modeling images was measured. Follow-up and radiographic examinations were performed. RESULTS A total of 17 studies (including 216 patients) about the application of CAD/CAM in the treatment of dentofacial deformities secondary to condylar osteochondroma have been reported since 2010, including the 8 present patients. In our study, all patients were satisfied with the surgical outcome, without obvious relapse or evidence of temporomandibular joint disorder or other complications during follow-up; all patients avoided condylar reconstruction and sagittal split of ramus osteotomy on the ipsilateral mandible side. Comparison between simulated plans and actual postoperative outcomes showed surgical simulation plan was accurately transferred to the actual surgery. CONCLUSIONS The application of CAD/CAM cutting and drilling guides as well as pre-bent titanium plates could achieve more accurate and favorable outcomes, improving the clinical planning and surgical execution for patients with condylar osteochondroma and secondary dentofacial deformities.
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Simultaneous Condylar Reconstruction by Free Ramus Osteotomy Graft After Complete Condylectomy for Osteochondroma. J Craniofac Surg 2021; 32:e477-e479. [PMID: 33481470 DOI: 10.1097/scs.0000000000007464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Mandibular condyle osteochondromas cause morphologic and functional disturbances. Multiple options exist for reconstructing the condylar segment following complete condylectomy. In this series, we describe 3 cases of mandibular condyle osteochondroma treated with complete condylectomy, orthognathic surgery, and a novel free ramus osteotomy graft. This is the first report to reconstruct the temporomandibular joint using a free ramus graft. Through this single-staged approach we were able to avoid recurrence, preserve function, and restore facial balance without a separate donor site or an alloplastic implant.
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Gerbino G, Segura-Pallerès I, Ramieri G. Osteochondroma of the mandibular condyle: Indications for different surgical methods: A case series of 7 patients. J Craniomaxillofac Surg 2021; 49:584-591. [PMID: 33994297 DOI: 10.1016/j.jcms.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/15/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022] Open
Abstract
The aim of this study was to evaluate and discuss the long-term outcomes of patients with condylar osteochondroma managed through 3 different surgical techniques. Seven patients with condylar osteochondroma treated in the author's department from May 2012 to January 2019 were included in this retrospective study. Clinical evaluations (visual analogue scale for TMJ pain, jaw function, symmetry, and quality of life), maximum interincisal opening (MIO) and radiological findings were collected pre- and postoperatively. Other parameters assessed included tumour size and location; complications and follow-up. Radical condylectomy with immediate total joint alloplastic reconstruction was performed in 4 patients, local excision in 2 patients and low condylectomy with concomitant orthognathic surgery in 1 patient. During an average follow-up period of 40,8 months no clinical or radiographic signs of recurrence were found. Average MIO increased from 25,5mm to 39,5mm at the longest follow up, and all clinical evaluations were greatly improved. In conclusion, the described surgical techniques appear valuable in the treatment of condylar osteochondroma. Local excision is indicated in tumor involving less than half the surface of the condylar head; radical condylectomy with immediate alloplastic total joint reconstruction is indicated in gigantic lesion compromising the anatomical components and function of the joint. Orthognathic surgery procedures should be combined with tumor resection when correction of associated dentofacial deformities is indicated.
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Affiliation(s)
- Giovanni Gerbino
- Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, Italy
| | - Ignasi Segura-Pallerès
- Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, Italy.
| | - Guglielmo Ramieri
- Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, Italy
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Hurrell M, Khabaz-Saberi S, Ricciardo PV. Management of deformity inducing osteochondroma of the temporomandibular joint: a case report. Aust Dent J 2021; 66:337-339. [PMID: 33450089 DOI: 10.1111/adj.12824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2021] [Indexed: 11/28/2022]
Abstract
Maxillofacial osteochondromas are considered benign neoplasms, and compared with their extracranial variant are relatively rare. When they involve the mandibular condyle they can induce significant facial deformity, malocclusion and various temporomandibular joint symptoms. Complete excision is considered the standard of care, but can lead to a reduction in the height of the ipsilateral mandible with resultant complications. In such cases, reconstruction is usually warranted and may be approached in various ways. This case report demonstrates a straightforward, accurate and reproducible approach to reconstructing the TMJ, facial profile and occlusion following resection of a large TMJ osteochondroma, without the need for concomitant orthodontics.
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Affiliation(s)
- Mjl Hurrell
- Royal Perth Hospital Oral and Maxillofacial Unit, Royal Perth Hospital, Perth, WA, Australia
| | - S Khabaz-Saberi
- Royal Perth Hospital Oral and Maxillofacial Unit, Royal Perth Hospital, Perth, WA, Australia
| | - P V Ricciardo
- Royal Perth Hospital Oral and Maxillofacial Unit, Royal Perth Hospital, Perth, WA, Australia
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Qi L, Cao N, Ge W, Jiang T, Fan L, Zhang L. A new method for individual condylar osteotomy and repositioning guides used in patients with severe deformity secondary to condylar osteochondroma. Orphanet J Rare Dis 2021; 16:59. [PMID: 33516245 PMCID: PMC7847561 DOI: 10.1186/s13023-021-01713-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background Mandibular condylar osteochondroma (OC) could lead to facial morphologic and functional disturbances, such as facial asymmetry, malocclusion, and temporomandibular joint dysfunction. However, after condylar OC resection, the inaccurate reposition of the neocondyle still needs to be solved. The purpose of this study was to explore the feasibility of the condylar osteotomy and repositioning guide to reposition the neocondyle in the treatment of patients with severe deformity secondary to condylar OC. Results Three patients with severe deformity secondary to OC of the mandibular condyle were enrolled in this study. With the aid of condylar osteotomy and repositioning guide, condylar OC resection and repositioning were carried out, and the accuracy and stability of these guides were evaluated. All patients healed uneventfully, and no facial nerve injury and condylar ankylosis occurred. Compared with the computerized tomography scans in centric relation before surgery and 3 days after surgery, the results showed that the facial symmetry was greatly improved in all the patients. Also, after the superimposition of the condylar segments before surgery and 3 days after surgery, the postoperative reconstructed condyles had a high degree of similarity to the reconstruction of the virtual surgical planning. Observed from the sagittal and coronal directions, the measurements of condylar positions were very close to those of virtual surgical planning. Moreover, it also showed stable results after a 1-year follow-up. Conclusions For patients with severe deformity secondary to condylar OC, condylar osteotomy, and repositioning guide was expected to provide a new option for the improvement of facial symmetry and occlusal relationship.
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Affiliation(s)
- Lei Qi
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ningning Cao
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Weiwen Ge
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Tengfei Jiang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.,National Clinical Research Center for Oral Diseases, Shanghai, 200011, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Linfeng Fan
- National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. .,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. .,Department of Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Lei Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. .,National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. .,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. .,Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.
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Lu C, Xie Q, He D, Yang C. Stability of Orthognathic Surgery in the Treatment of Condylar Osteochondroma Combined With Jaw Deformity by CT Measurements. J Oral Maxillofac Surg 2020; 78:1417.e1-1417.e14. [PMID: 32339481 DOI: 10.1016/j.joms.2020.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE We evaluated the stability of orthognathic surgery in the treatment of unilateral condylar osteochondroma combined with jaw deformity. PATIENTS AND METHODS Patients with unilateral condylar osteochondroma and jaw deviation deformity who had undergone surgery at the Ninth People's Hospital of Shanghai Jiaotong University School of Medicine from July 2014 to March 2017 were enrolled. The operation included a low condylectomy and both Le Fort I osteotomy and bilateral mandibular sagittal split osteotomies. ProPlan CMF, version 1.4, software (Materialise, Leuven, Belgium) was used to reconstruct and measure the preoperative, immediately postoperative, and follow-up (>6 months) maxillofacial computed tomography images. The position of the jaw and contralateral condyle and remodeling of the affected side were compared during follow-up. RESULTS Eight patients were included in the present study. The canting of the maxilla was significantly decreased postoperatively, and the contralateral condyle had rotated inward. The position of the maxillary and contralateral condyles was stable during follow-up, and the posterior aspect of the affected condyle demonstrated significant resorption. CONCLUSIONS The results of single-stage surgery combined with orthognathic surgery and condylar osteochondroma resection were stable, and the affected condyle stump had adaptively reconstructed.
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Affiliation(s)
- Chuan Lu
- Attending Surgeon, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China
| | - Qianyang Xie
- Attending Surgeon, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China
| | - Dongmei He
- Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China.
| | - Chi Yang
- Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China
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Kau CH, Almakky O, Louis PJ. Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements. J Orthod 2020; 47:156-162. [PMID: 32126863 DOI: 10.1177/1465312520908276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case report describes the successful second surgical treatment of a 26-year-old white female patient with a retrognathic mandible and previous bilateral total joint prostheses placement. The patient had previously presented with bilateral idiopathic condylar resorption (ICR) which caused clockwise mandibular rotation and resulted in anterior open bite and a retrognathic mandible. The patient had undergone definitive corrective for the ICR where condylectomies were performed bilaterally. In addition, total joint prostheses using 'stock joints' were used to restore the condyle and glenoid fossa on both sides. Although the previous surgery corrected the anterior open bite and restored the condyles, the patient was still suffering from joint symptoms (significant pain), restricted mandibular movements, increased overjet (12 mm) and a retrognathic mandible. The treatment plan included a combined orthodontic surgical approach: (1) bimaxillary orthognathic surgery: a surgical procedure on the mandible to reposition the prosthetic joints and correct the mandible position, and a segmental LeFort I to expand the maxilla; and (2) post-surgical orthodontics treatment to detail the occlusion. At the end of the treatment, good aesthetic and functional results were obtained with the cooperation of two specialties. This case emphasises the importance of three-dimensional planning and multidisciplinary treatment when addressing complex jaw movements. It also emphasises the importance orthodontic planning and collaboration with the orthodontist.
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Affiliation(s)
- Chung H Kau
- Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Omar Almakky
- Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patrick J Louis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, AL, USA
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Spontaneous Condyle-Like Development after Total Resection of Mandible Giant Osteochondroma: Case Report and a Follow-Up for Five Years. Case Rep Surg 2020; 2020:3720909. [PMID: 32089940 PMCID: PMC7026717 DOI: 10.1155/2020/3720909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/24/2020] [Indexed: 11/27/2022] Open
Abstract
Osteochondroma manifests as a benign tumor that occurs as an abnormal bony development. This tumor is commonly asymptomatic and presents an exophytic outgrowth on bone surfaces, near synovial joints, a condition that invariably induces evident facial deformities. Treatment for this type of tumor usually involves a surgical approach promoting a total or partial resection of the affected anatomical area associated to prosthetic reconstruction of the bone area extracted. We present a case report about a giant mandibular condyle osteochondroma in a 37-year-old female patient. Her treatment involved a total condylectomy without immediate condylar reconstruction, which would be performed in a posterior surgical approach. During the patient's follow-up (every 6 months of post operation), a spontaneous and rudimentary condyle-like formation was observed. Because the stomatognathic function and facial harmony were satisfactory, we observed the condyle-like development for 5 years of follow-up. Also, because both the aesthetic aspect and functional evolution of the maxillary bone were considered satisfactory, no complementary reconstruction surgical treatment was required for the giant osteochondroma of the mandibular condyle.
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Abstract
One of the indications of the surgical approach of the temporomandibular joint is the presence of foreign body in its interior. However, joint handling offers risks, especially bleeding. In these cases, angiography and embolization of the arteries involved with the projectile play an important role in the prevention of complications. In this report, the authors describe a case of a 23-year-old male victim of firearm attack with comminuted fracture of the right mandibular condyle. The patient underwent angiography and prophylactic embolization of the arteries adjacent to the foreign body. A surgical procedure was performed to remove the projectile and bone fragments with the aid of the X-ray image intensifier, which resulted in the restoration of mandibular function, absence of joint pain, and satisfactory dental occlusion. This case shows the importance of auxiliary imaging methods for performing a safe surgical procedure for removal of ballistic and bony fragments from the interior of the temporomandibular joint.
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Bouloux GF, Roser SM, Abramowicz S. Pediatric Tumors of the Temporomandibular Joint. Oral Maxillofac Surg Clin North Am 2018; 30:61-70. [PMID: 29153238 DOI: 10.1016/j.coms.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The incidence of tumors and pseudotumors of the temporomandibular joint (TMJ) in the pediatric population is low. They are often challenging to recognize unless associated with signs and symptoms that may erroneously be interpreted as TMJ dysfunction. Tumors of the TMJ can be divided into 3 categories based on the nature and type of precursor cell involved in the tumor: benign tumors, malignant tumors, and pseudotumors. This article discusses the most common entities in these categories.
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Affiliation(s)
- Gary F Bouloux
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA
| | - Steven M Roser
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA; Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA 30322, USA
| | - Shelly Abramowicz
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365 Clifton Road, Atlanta, GA 30322, USA; Section of Dentistry/Oral and Maxillofacial Surgery, Children's Healthcare of Atlanta, 1405 Clifton Road, Atlanta, GA 30322, USA.
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