Osteosarcoma of the temporomandibular joint: report of 2 cases

A detunable wireless resonator insert for high-resolution TMJ MRI at 1.5 T

MRI is essential for evaluating and diagnosing various conditions affecting the temporomandibular joint (TMJ) and surrounding structures, as it provides highly detailed images that enable healthcare professionals to assess the joints and surroundings in great detail. While commercial MRI scanners typically come equipped with basic receive coils, such as the head receive array, RF coils tailored for specialized applications like TMJ MRI must be obtained separately. Consequently, TMJ MRI scans are often conducted using the head receive array, yet this configuration proves suboptimal due to the lack of specialized coils. In this study, we introduce a simple, low-cost, and easy-to-reproduce wireless resonator insert to enhance the quality of TMJ MRI at 1.5 T. The wireless resonator shows a significant improvement in signal-to-noise ratio (SNR) and noticeably better imaging quality than the head array alone configuration in both phantom and in vivo images.

MRI in a case of osteosarcoma in the temporomandibular joint

Osteosarcoma of the temporomandibular joint (TMJ) is rare. We report a case of osteosarcoma in the TMJ of a 62-year-old female, pre-operatively diagnosed to have a benign tumour, and discuss the usefulness and limits of MRI using a TMJ coil as a diagnosis.

[Temporomandibular joint primitive tumors and pseudo tumors]

The temporomandibular joint (TMJ) can be the site of bone, cartilaginous, or synovial tumors. There is no well-defined histological classification. We listed all benign tumors, malignant primitive tumors, and rare pseudo tumors of the TMJ. We provide a list to help for the diagnosis and the differential diagnosis of non-tumoral lesions by far the most frequent.

Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: the importance of ongoing oral examinations

Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment.

Evaluation of simulated bone lesion in the head of the mandible by using multislice computed tomography

Conventional radiography has shown limitation in acquiring image of the ATM region, thus, computed tomography (CT) scanning has been the best option to the present date for diagnosis, surgical planning and treatment of bone lesions, owing to its specific properties. Objective: The aim of the study was to evaluate images of simulated bone lesions at the head of the mandible by multislice CT. Material and methods: Spherical lesions were made with dental spherical drills (sizes 1, 3, and 6) and were evaluated by using multislice CT (64 rows), by two observers in two different occasions, deploying two protocols: axial, coronal, and sagittal images, and parasagittal images for pole visualization (anterior, lateral, posterior, medial and superior). Acquired images were then compared with those lesions in the dry mandible (gold standard) to evaluate the specificity and sensibility of both protocols. Statistical methods included: Kappa statistics, validity test and chi-square test. Results demonstrated the advantage of associating axial, coronal, and sagittal slices with parasagittal slices for lesion detection at the head of the mandible. Results: There was no statistically significant difference between the types of protocols regarding a particular localization of lesions at the poles. Conclusions: Protocols for the assessment of the head of the mandible were established to improve the visualization of alterations of each of the poles of the mandible's head. The anterior and posterior poles were better visualized in lateral-medial planes while lateral, medial and superior poles were better visualized in the anterior-posterior plane.

Validity of single- and multislice CT for assessment of mandibular condyle lesions

OBJECTIVES

The purpose of this study was to evaluate and to compare the validity of the different CT image protocols (single- and multislice CT) in the analysis of simulated mandibular condyle lesions.

METHODS

Simulated lesions were created in 15 dry mandibles using a dental round burr. The mandibles were then submitted to a single slice CT, and the same specimens were subsequently submitted to a multislice CT. The analysis was performed by two previously calibrated examiners in four protocols: (1) single slice-axial, (2) multislice-axial, (3) single slice-axial/multiplanar reconstructed (MPR) and (4) multislice-axial/MPR. The examiners evaluated the absence or presence of bony destruction and their localization in each protocol, considering also some bony erosion caused by its reabsorption. Statistical analysis was carried out using validity and chi(2) tests to compare the protocols.

RESULTS

Protocol 1 presented the lowest validity values (62.7%). The validity of Protocols 2 and 3 was 66.2% and 72.7%, respectively. The highest value of validity was 93.1% and corresponded to Protocol 4.

CONCLUSIONS

All CT-imaging protocols were considered accurate for mandibular condyle lesions assessment. The association of axial with MPR images using multislice CT demonstrated highest accuracy. A new imaging protocol was established for diagnosis of these lesions.

Computed tomography imaging findings of simultaneous bifid mandibular condyle and temporomandibular joint ankylosis: case report

Bifid mandibular condyle is an uncommon entity described in the literature as having a controversial etiology. Despite the absence of clinical symptomatology, the radiologist must be aware and should have some knowledge of this abnormality, as well its implications regarding functional and morphological changes. TMJ ankylosis is a disabling disease with involvement of the mandibular condyle, articular fossa and base of the skull. The association of bifid condyle with temporomandibular joint ankylosis is rare and must be carefully evaluated. The purpose of this paper is to report a case of simultaneous bifid mandibular condyle and temporomandibular joint ankylosis and to describe its computed tomography imaging findings.

Orofacial Pain--Part II: Assessment and management of vascular, neurovascular, idiopathic, secondary, and psychogenic causes

Chronic orofacial pain is a common health complaint faced by health practitioners today and constitutes a challenging diagnostic problem that often requires a multidisciplinary approach to diagnosis and treatment. The previous article by the same authors in this issue discussed the major clinical characteristics and the treatment of various musculoskeletal and neuropathic orofacial pain conditions. This second article presents aspects of vascular, neurovascular, and idiopathic orofacial pain, as well as orofacial pain due to various local, distant, or systemic diseases and psychogenic orofacial pain. The emphasis in this article is on the general differential diagnosis and various therapeutic regimens of each of these conditions. An accurate diagnosis is the key to successful treatment of chronic orofacial pain. Given that for many of the entities discussed in this article no curative treatment is available, current standards of management are emphasized. A comprehensive reference section has been included for those who wish to gain further information on a particular entity.

Osteoblastic Osteosarcoma of the Mandible: Findings on Tc-99m HMDP Bone and Ga-67 Citrate Scintigraphy

A 25-year-old woman presented with a disturbance in the opening of her mouth 5 months before admission. On admission, painful swelling of the right preauricular region was revealed. Computed tomography (CT) demonstrated a soft tissue density mass around the right condylar process of the mandible. Tc-99m hydroxymethylene diphosphonate (HMDP) bone scintigraphy and Ga-67 citrate scintigraphy showed avid uptake in the mass. The tumor was histologically identified as an osteoblastic osteosarcoma of the right mandible. There are few reports of Ga-67 citrate scintigraphy findings of osteoblastic osteosarcoma of the mandible. The accumulation patterns on Tc-99m HMDP bone scintigraphy and Ga-67 citrate scintigraphy are possibly characteristic of osteoblastic osteosarcoma of the mandible.

The temporomandibular joint: clinical and surgical aspects

Advances in imaging techniques have greatly enhanced the ability to visualize the internal anatomy of the temporomandibular joint and have increased understanding of the etiology of many temporomandibular disorders. When used together with careful history and physical examination, this knowledge can contribute to better treatment outcomes.