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Owosho AA, Aguirre SE, Dayo AF, Omolehinwa TT, Shintaku WH. Radiographic Orofacial Findings of Systemic Diseases. Dent Clin North Am 2024; 68:409-427. [PMID: 38417998 DOI: 10.1016/j.cden.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article discusses the orofacial clinicoradiographic features of systemic diseases that manifest in the orofacial region. The systemic diseases discussed are grouped into the following: autoimmune diseases, endocrine diseases, bone diseases, hematologic diseases, syndromes, and malignancies. The radiographic manifestation ranges from radiolucent bony destruction, increased bone density, calcification, thinning of cortical plate, loss of trabeculation, missing teeth, and supernumerary teeth. It is imperative for clinicians to be cognizant of these findings, as they may be the first manifestation of these systemic diseases.
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Affiliation(s)
- Adepitan A Owosho
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Sarah E Aguirre
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adeyinka F Dayo
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Temitope T Omolehinwa
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Werner H Shintaku
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN, USA
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Oliver C, Mouallem G, Dutot-Philipeau N, Longis J, Piot B, Bertin H. A case report of condyle metastasis and a review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:360-363. [PMID: 33965657 DOI: 10.1016/j.jormas.2021.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
Metastasis of the oral cavity is a rare condition and should be investigated for a primary tumor in the lungs, breast, kidney and prostate. Involvement of the mandibular condyle frequently mimics TMJ dysfunction with pain, swelling and limitation of mouth opening. We report the case of atypic TMJ dislocation as an inaugural sign of condyle metastasis. We also discuss the diagnostic approach by a brief review of the literature.
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Affiliation(s)
- Charlotte Oliver
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Guillaume Mouallem
- Chirurgie maxillo-faciale et stomatologie, Polyclinique du Parc, avenue des Sables, CS 60908, 49300 Cholet, France.
| | - Noémie Dutot-Philipeau
- Chirurgie maxillo-faciale et stomatologie, Santé Atlantique, avenue Claude Bernard, 44800 Saint-Herblain, France.
| | - Julie Longis
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Benoit Piot
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France.
| | - Hélios Bertin
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, 1 place Alexis Ricordeau, 44093 Nantes, France; Laboratoire des sarcomes osseux et remodelage des tissus calcifiés (Phy.Os UMR1238), faculté de médecine, 1 rue Gaston Veil, 44000 Nantes, France.
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3
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Gangwani P, Sadda A, Danakas A, Kolokythas A. Metastatic disease to the condyle: A case report and review of literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pancreatic Carcinoma Metastatic to the Gingiva. Clin Pract 2021; 11:58-64. [PMID: 33572607 PMCID: PMC7931014 DOI: 10.3390/clinpract11010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 12/05/2022] Open
Abstract
Metastatic tumors to the oral cavity are uncommon, representing approximately 1% of all cases of oral malignant lesions even when a metastatic disease is present. The 53-year-old female is presented complaining of abdominal pain, weight loss, and a loose stool recurring not more than three times per day. A computed tomography (CT) scan of the abdomen showed a retroperitoneal mass expanding along the body of the pancreas. Colonoscopy and gastroscopy with a gastric mucosa biopsy showed a normal result. After laparoscopic surgery, the primary site of adenocarcinoma was not confirmed. The patient was referred to the Maxillofacial Surgery Clinic with pain, swelling, and occasional bleeding around the lower right second mollar. Immunohistochemicaly, the tumor cells were positive for Cytokeratin (CK) 19, Cytokeratin (CK) 7, and homebox protein (CDX-2), which are highly sensitive markers of pancreatobiliar cancer. Therefore, the patient was diagnosed with pancreatic carcinoma. This report describes a rare metastasis of malignant pancreatic tumor to the lower right gingiva and highlights the importance of immunohistochemical examination and how it helped identify both the origin and the nature of gingival neoplasm.
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Salamon NM, Casselman JW. Temporomandibular Joint Disorders: A Pictorial Review. Semin Musculoskelet Radiol 2020; 24:591-607. [PMID: 33036046 DOI: 10.1055/s-0040-1701631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Temporomandibular joint (TMJ) disorders are commonly encountered in the general population but often ignored or unrecognized. The detection and characterization of lesions has drastically improved over the years due to technological advances in cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). However, adequate knowledge of the normal imaging appearance on different imaging modalities as well as the broad variety of pathology is required to provide a proper radiologic assessment. This pictorial review focuses on TMJ pathology and its appearance on CBCT and MRI. A short overview of the technical aspects and normal anatomy are provided to round out this complete summary on the subject.
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Affiliation(s)
- Nicolas M Salamon
- Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium.,Department of Radiology, Ghent University Hospital, Ghent, Belgium
| | - Jan W Casselman
- Department of Radiology, AZ Sint-Jan Brugge, Bruges, Belgium.,Department of Radiology, Ghent University Hospital, Ghent, Belgium.,Department of Radiology, GZA Sint-Augustinus Antwerp, Antwerp, Belgium
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Leite-Lima F, Fonseca FP, Gomez RS, Lehman LFC, de Castro WH, Campos FEB. A nodule in the temporomandibular joint area. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 130:4-9. [PMID: 32173388 DOI: 10.1016/j.oooo.2019.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/22/2019] [Accepted: 03/21/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Flávia Leite-Lima
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Wagner Henriques de Castro
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Eduardo Baires Campos
- Department of Oral and & Maxillofacial Surgery, Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Dodo M, Kumagai M, Kato Y, Hirakawa H, Koseki T. Metastasis in the mandibular condyle: a case report. J Med Case Rep 2017; 11:323. [PMID: 29141669 PMCID: PMC5688695 DOI: 10.1186/s13256-017-1450-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/12/2017] [Indexed: 12/03/2022] Open
Abstract
Background Most bone metastases are observed in the trunk of the body. Metastasis in the mandibular condyle is rare. In many case reports, temporary common temporomandibular joint disorder-like symptoms can be a sign of relapse and metastasis. Case presentation We report a rare case of breast carcinoma metastatic to the left mandibular condyle in a 55-year-old Japanese woman, who visited our department for a dental check-up prior to chemotherapy. She had almost no symptoms, but radiographs suggested the existence of metastasis. Conclusions In many case reports, patients had some symptoms. In this case report, our patient had slight symptoms, but we were able to confirm the metastasis from the symptoms and panoramic dental radiograph. When patients complain about discomfort of the temporomandibular joint, we need to consider the possibility of metastasis and notice changes on the panoramic dental radiograph.
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Affiliation(s)
- Mina Dodo
- Division of Preventive Dentistry, Department of Oral Health and Development Sciences, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Masahiro Kumagai
- Department of Oral and Maxillofacial Surgery, Tohoku Kosai Hospital, Sendai, Japan
| | - Yuta Kato
- Department of Dentistry and Oral and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Takeyoshi Koseki
- Division of Preventive Dentistry, Department of Oral Health and Development Sciences, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Suenaga S, Nagayama K, Nagasawa T, Indo H, Majima HJ. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders. JAPANESE DENTAL SCIENCE REVIEW 2016; 52:93-106. [PMID: 28408961 PMCID: PMC5390340 DOI: 10.1016/j.jdsr.2016.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 04/14/2016] [Accepted: 04/26/2016] [Indexed: 12/30/2022] Open
Abstract
The causes of pain symptoms in the temporomandibular joint (TMJ) and masticatory muscle (MM) regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs) are associated with computed tomography and magnetic resonance (MR) findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.
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Affiliation(s)
- Shigeaki Suenaga
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Kunihiro Nagayama
- Department of Orthodontics and Dentofacial Orthopedics, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Taisuke Nagasawa
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hiroko Indo
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hideyuki J. Majima
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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Diagnosis of temporomandibular joint disorders: indication of imaging exams. Braz J Otorhinolaryngol 2016; 82:341-52. [PMID: 26832630 PMCID: PMC9444643 DOI: 10.1016/j.bjorl.2015.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 05/27/2015] [Accepted: 06/16/2015] [Indexed: 10/26/2022] Open
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10
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Metastatic pancreatic adenocarcinoma to the mandibular condyle: a rare clinical presentation. J Oral Maxillofac Surg 2013; 72:83-8. [PMID: 23911149 DOI: 10.1016/j.joms.2013.06.207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 11/24/2022]
Abstract
Metastatic disease to the oral cavity is rare, representing only 1-8% of oral malignancies, and involvement of the mandibular condyle is even less prevalent. In a recent literature review of 796 cases of metastatic disease to the oral cavity, only 39 (13.8%) involved the condyle. This report is a unique case of metastatic pancreatic adenocarcinoma to the condyle. There are only 5 documented cases of metastatic pancreatic adenocarcinoma to the oral cavity, one of which metastasized to the condyle. This is an important case because metastatic lesions to the condyle may mimic temporomandibular joint disorders making clinical diagnosis and decision-making extremely challenging for the oral and maxillofacial surgeon. The requirement for arrival at an appropriate and prompt diagnosis is crucial for determining the most appropriate treatment regimens and improved outcomes. Additionally, in approximately 33% of cases, the oral metastatic lesion may be the first indication of an undiscovered distant primary tumor, making timely evaluation and treatment critical from an oncologic perspective.
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Qiu YT, Yang C, Chen MJ, Qiu WL. Metastatic Spread to the Mandibular Condyle as Initial Clinical Presentation: Radiographic Diagnosis and Surgical Experience. J Oral Maxillofac Surg 2013; 71:809-20. [DOI: 10.1016/j.joms.2012.07.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 07/08/2012] [Accepted: 07/12/2012] [Indexed: 12/11/2022]
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Pigmented villonodular synovitis of the temporomandibular joint: case report and review of the literature. ACTA ACUST UNITED AC 2011; 111:e17-28. [PMID: 21310347 DOI: 10.1016/j.tripleo.2010.11.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/31/2010] [Accepted: 11/26/2010] [Indexed: 02/06/2023]
Abstract
Pigmented villonodular synovitis (PVNS) is an aggressive proliferative lesion that usually involves the synovial tissues of big joints. To date, there are ∼52 cases of PVNS affecting the temporomandibular joint reported in the English-language literature, about one-third of them exhibiting intracranial involvement. We herein describe an additional case of PVNS of the temporomandibular joint with skull base invasion affecting a 26-year-old male patient and discuss its clinicopathologic features considering previously published cases. Histopathology and imaging evaluation are important for the diagnosis of PVNS, which should be included in the differential diagnosis of preauricular aggressive swellings.
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