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Deng H, Peng S, Wu F, An R, Wang J. Rare Recurrent Giant Frontal Osteoma With Skin Multiple Keratinous Cysts and Multinucleated Giant Cell Granulomas. J Craniofac Surg 2023; 34:1829-1833. [PMID: 37316991 DOI: 10.1097/scs.0000000000009483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Osteoma is the most common benign tumor of the craniomaxillofacial region. Its etiology remains unclear, and the computed tomography and histopathologic examination contribute to its diagnosis. There are very rare reports of recurrence and malignant transformation after surgical resection. Furthermore, giant frontal osteomas that occurred repeatedly and were accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas have not been reported in previous literature. METHODS The previous cases of recurrent frontal osteoma in the literature and all cases of frontal osteoma in our department in the last 5 years were reviewed. RESULTS A total of 17 cases of frontal osteoma (mean age 40 y, all female) were reviewed in our department. All patients underwent open surgery to remove the frontal osteoma, and no evidence of complications was found during postoperative follow-up. Two patients underwent 2 or more operations due to the recurrence of osteoma. CONCLUSIONS Two cases of recurrent giant frontal osteoma were reviewed emphatically in this study, including 1 case of giant frontal osteoma with skin multiple keratinous cysts and multinucleated giant cell granulomas. As far as we know, this is the first giant frontal osteoma that occurred repeatedly and was accompanied by skin multiple keratinous cysts and multinucleated giant cell granulomas.
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Affiliation(s)
- Huiling Deng
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Shuyi Peng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Wu
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Ran An
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
| | - Jiecong Wang
- Department of Plastic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Peripheral Osteoma of the Mandibular Condyle—Case Series. Dent J (Basel) 2022; 10:dj10100182. [PMID: 36285992 PMCID: PMC9600507 DOI: 10.3390/dj10100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
The purpose of this article is to present four new cases of peripheral osteoma of the mandibular condyle and the literature review. A retrospective study of files from our Department of Oral and Maxillofacial Surgery over the last 6 years revealed four cases of peripheral osteomas located in the area of the mandibular condyle. Diagnostic procedure included clinical, radiographic, and histologic criteria. Gardner’s syndrome was excluded from patient history and clinical evaluation. One patient had only an aesthetic disturbance, with facial swelling, and the other three patients presented disturbances of the mandibular function, including deviation during mouth opening along with malocclusion. Three of the patients were male and one was female; all were of middle age (45–65 years old). The proposed surgical treatment was accepted by half of the patients, while the remaining half declined the operation after a confirmation of the diagnosis. Peripheral osteomas of the maxillofacial region are uncommon, and some cases with multiple osteomas are related to Gardner’s syndrome. An osteoma of the mandibular condyle is very rare and surgical treatment is challenging for the surgeon with regards to the approach selection and the related complications. In the two cases that accepted the proposed surgical treatment, no recurrence and no complication was observed.
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Wolf-Grotto I, Nogueira LM, Milani B, Marchiori EC. Management of giant osteoma in the mandible associated with minor trauma: a case report. J Med Case Rep 2022; 16:8. [PMID: 34996519 PMCID: PMC8742411 DOI: 10.1186/s13256-021-03217-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoma is a benign tumor of the bones, which can be classified as central or peripheral. The occurrence in the jawbones is uncommon, but when it occurs, there is a greater prevalence of the mandible. The etiology is still unknown, and the hypothesis of its development is debated. CASE PRESENTATION A 35-year-old Caucasian man presenting a tumor lesion in the right jawbone that had been growing for 8 years sought medical service complaining of speaking impairment. According to the patient, the tumor appeared shortly after a minor trauma caused by tooth extraction. The diagnosis of the lesion was made through clinical, radiographic, and histological methods, and the surgical treatment was successful and satisfactory for the patient as well as the surgical team, despite a short follow-up. CONCLUSION Etiopathogenesis of osteoma is not determined in the majority of cases. In the present report, it was possible to hypothesize the association between a minor trauma and the development of the tumor, reinforcing the reactive theory of tumor development. The uncommon location of the osteoma, as well the possibility of identifying the possible cause of the lesion, makes this case particularly interesting.
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Affiliation(s)
- Isabela Wolf-Grotto
- Division of Oral and Maxillofacil Surgery, Municipal Hospital Dr. Fernando Mauro Pires da Rocha, Estrada de Itapecerica, 1661, Vila Maracanã, São Paulo, Zip Code 05835-005, Brazil.
| | - Lucas M Nogueira
- Division of Oral and Maxillofacil Surgery, Municipal Hospital Dr. Fernando Mauro Pires da Rocha, Estrada de Itapecerica, 1661, Vila Maracanã, São Paulo, Zip Code 05835-005, Brazil
| | - Basilio Milani
- Residence Program of Municipal Hospital Dr. Fernando Mauro Pires da Rocha, São Paulo, Brazil
| | - Erica C Marchiori
- Preceptor in Oral and Maxillofacial Surgery Residence Program of Municipal Hospital Dr, Fernando Mauro Pires da Rocha, São Paulo, Brazil
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Ortega Beltrá N, Matarredona Quiles S, Martín Arroyo M, Pons Rocher F. Mandibular osteoma as a cause of ankylosis and progressive trismus. BMJ Case Rep 2021; 14:e244014. [PMID: 34551913 PMCID: PMC8461283 DOI: 10.1136/bcr-2021-244014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2021] [Indexed: 11/04/2022] Open
Abstract
Osteomas are benign tumours of bone tissue restricted to the craniofacial skeleton. The aim of this article is to present and discuss the demographic and clinical aspects and the management of craniomaxillofacial osteomas. When the patient was submitted from primary care to our hospital, he was 68 years old, and he had ankylosis of the temporomandibular joint for the previos 4 years. A CT scan was performed, finding a giant mandibular osteoma. Conservative treatment and radiological follow-up were carried out with clinical stability. Osteomas more often are seen in the paranasal sinuses and in young adults, with no differences in gender. Most are asymptomatic, but they can cause local problems. For its diagnosis, CT is usually performed. Treatment options are conservative management and follow-up or surgery. Although rarely, they can recur. Mandibular peripheral osteoma is a rare entity. Depending on the symptoms, a conservative or surgical treatment can be chosen. A clinical and radiological follow-up is necessary to detect possible recurrences or enlargement.
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Affiliation(s)
| | | | | | - Francisco Pons Rocher
- Cirurgia, Universitat de Valencia Facultat de Medicina i Odontologia, Valencia, Spain
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Farajpour H, Bastami F, Bohlouli M, Khojasteh A. Reconstruction of bilateral ramus-condyle unit defect using custom titanium prosthesis with preservation of both condyles. J Mech Behav Biomed Mater 2021; 124:104765. [PMID: 34509905 DOI: 10.1016/j.jmbbm.2021.104765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/14/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Novel technologies for management and reconstruction of complex bony defects regarding both function and facial appearance are interestingly used in maxillofacial surgery. In the current study, we demonstrated reconstruction of a bilateral ramus-condyle unit (RCU) defect while preserving both condyles by a novel designed titanium prosthesis using virtual surgical planning (VSP), computer-aided design and manufacturing (CAD/CAM), and Selective Laser Melting (SLM) technologies. MATERIALS AND METHODS A 3D customized titanium prosthesis was designed for a 49 -year-old patient with bilateral mandibular aggressive central giant cell granuloma (CGCG) according to mandibular normal anatomy and structure while preserving bilateral intact condyles. Finite element study was performed to investigate the effects of new design strength and the stress shielding phenomenon. The design of macro-pores inside the body of prosthesis allowed it to act as a scaffold for bone tissue engineering under load bearing conditions. RESULTS Analysis of the strength and stress shielding phenomenon demonstrated favorable outcomes regarding the novel design. For instance, there was no stress shielding in any of the preserved condyles with regard to the size and distribution of stresses. Also, the stress distribution around the pores showed that these pores had no effect on the strength of the prosthesis. Thirty month follow-ups after reconstruction of bilateral RCU defect showed normal jaw function with a favorable facial appearance and mandibular contour. CONCLUSION We design a novel patient-specific prosthesis with desirable biomechanical features for reconstruction of bilateral RCU defect after resection of the benign tumor with preservation of bilateral intact condyles.
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Affiliation(s)
- Hekmat Farajpour
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshid Bastami
- Department of Oral and Maxillofacial Surgery, and Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Bohlouli
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Guest Professor, Faculty of Health and Medicine, University of Antwerp, Antwerp, Belgium.
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Mehrotra D, Kumar S, Mehrotra P, Khanna R, Khanna V, Eggbeer D, Evans P. Patient specific total temporomandibular joint reconstruction: A review of biomaterial, designs, fabrication and outcomes. J Oral Biol Craniofac Res 2021; 11:334-343. [PMID: 33786297 DOI: 10.1016/j.jobcr.2021.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/03/2021] [Accepted: 02/16/2021] [Indexed: 01/23/2023] Open
Abstract
Purpose The aim of this article was to systematically review the available literature on patient specific total temporomandibular joint total joint replacement (PS-TMJR) implants for their biomaterial, designs, fabrication techniques and their outcomes. Methods A literature review was conducted using PubMed, and science direct databases using the key words three-dimensional printing, 3D printing, CAD CAM, computer aided designing, computer aided manufacturing, additive technology, custom made implants, patient specific implants in combination with Temporomandibular joint, TMJ surgery. Results The search revealed 2760 articles, of which 374 were in English and discussed TMJ reconstruction. Further filtering shortlisted 74 articles that discussed PS-TMJR. Duplicates were removed and additional added from article references. 39 articles describing biomaterial, designing and fabrication of PS-TMJR implants and their outcomes were selected for analysis. Conclusions Although PS-TMJR implants allow a better anatomical fit, improved fixation, and safeguard various structures such as the inferior alveolar nerve, they vary in designs, material and fabrication techniques. However, PS-TMJR printed with SLM and EBM technologies have yet to be compared with the conventional ones in terms of mechanical strength, and clinical outcome. With emerging bioprinting technologies, even newer biomaterials should be considered for 3D printing of PS-TMJR devices designed to achieve harmony in function between the joint device, bone and masticatory muscles.
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Affiliation(s)
- Divya Mehrotra
- Dept of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Sumit Kumar
- Dept of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Pankhuri Mehrotra
- Dept of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Richa Khanna
- Dept of Preventive and Paediatric Dentistry, King George's Medical University, Lucknow, India
| | - Vikram Khanna
- Dept of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | | | - Peter Evans
- Healthcare Consultant in Maxillofacial Prosthetics, Maxillofacial Laboratory, Morriston Hospital, Swansea, Wales, UK
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Custom Alloplastic Temporomandibular Joint Reconstruction: Expanding Reconstructive Horizons. J Craniofac Surg 2021; 31:1651-1658. [PMID: 32569038 DOI: 10.1097/scs.0000000000006595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Custom alloplastic temporomandibular joint (TMJ) reconstruction has been well established for the management of end-stage TMJ disease. However, its use in congenital TMJ deformities is limited. Here, the authors present initial outcomes of skeletally mature patients who underwent custom alloplastic TMJ reconstruction and simultaneous orthognathic surgery.A retrospective case series of patients who underwent custom alloplastic TMJ reconstruction concurrent with orthognathic surgery between 2014 and 2019 was completed. Functional, aesthetic and orthodontic outcomes as well as complications were recorded.Seven TMJs in 5 skeletally mature patients (4 female, 1 male, ages 16-30) (2 bilateral, 3 unilateral) were replaced. All but 1 patient had previous attempts at reconstructive surgery with poor results. All cases were prepared using virtual surgical planning and underwent concomitant maxillomandibular orthognathic surgery. All patients demonstrated improved post-operative occlusions. Four of 5 patients achieved >30 millimeters of post-operative MIO. Complications included ear canal perforation and facial nerve dysfunction.There were no infections or other implant-related complications. Mean follow up was 2 years and 15 days. Alloplastic TMJ reconstruction at the time of skeletal maturity for patients with congenital mandibular TMJ defects is an alternative to existing management options. Further long-term prospective outcomes studies are ongoing.
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Lazar A, Brookes CCD. Giant Osteomas: Optimizing Outcomes Through Virtual Planning; a Report of Two Cases and Review of the Literature. J Oral Maxillofac Surg 2020; 79:366-375. [PMID: 32857957 DOI: 10.1016/j.joms.2020.07.210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
Osteomas are benign slow-growing tumors of compact or cancellous bone. They are often asymptomatic. However, a rare variety of "giant" osteomas exists, which can reach an impressive size, causing both functional and cosmetic concerns. The location and size of these lesions can make surgical intervention challenging. Here we present 2 cases of giant osteomas in which 3-dimensional planning was of great aid in optimizing functional and esthetic outcomes, and review the literature related to giant osteomas of the mandible.
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Affiliation(s)
- Ashley Lazar
- Resident, PGY-1, Division of Oral and Maxillofacial Surgery, Medical College of Wisconsin, Milwaukee, WI
| | - Carolyn C D Brookes
- Assistant Professor, Division Chief, Residency Program Director, Division of Oral and Maxillofacial Surgery, Medical College of Wisconsin, Milwaukee, WI.
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Abstract
Osteomas are bone tumours arising from the cortical or medullary bones of craniofacial skeleton. Involvement of frontal bone and paranasal sinuses is more frequent than jaw bones. Jaw osteomas are slow growing benign lesions, which are usually asymptomatic or present as painless swelling. Those involving mandibular condyle are relatively rare and result in significant functional and aesthetic disturbances. This paper reports a case of solitary central compact osteoma of mandibular condyle in an adult Indian female patient. A comprehensive review of previously published reports is also presented.
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Affiliation(s)
- Kumar Nilesh
- Oral and Maxillofacial Surgery, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Aaditee Vande
- Prosthodontics, Crown and Bridge, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sridhar Reddy
- Department of Oral and Maxillofacial Surgery, Hyderabad Government Dental College and Hospital, Hyderabad, Telangana, India
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Ostrofsky M, Morkel J, Titinchi F. Osteoma of the mandibular condyle: a rare case report and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 120:584-587. [DOI: 10.1016/j.jormas.2019.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/23/2018] [Accepted: 01/20/2019] [Indexed: 01/26/2023]
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11
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Elledge R, Mercuri L, Attard A, Green J, Speculand B. Review of emerging temporomandibular joint total joint replacement systems. Br J Oral Maxillofac Surg 2019; 57:722-728. [DOI: 10.1016/j.bjoms.2019.08.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/14/2019] [Indexed: 10/26/2022]
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Affiliation(s)
| | | | - Shaza Mardini
- University of Tennessee, Graduate School of Medicine, Knoxville, TN
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13
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Abstract
Background: Osteoma is a benign tumor composed of both cortical and cancellous bones that increase in size with continuous formation of bone. The pathogenesis is unknown. Osteomas can cause symptoms depending on their location and size. They can be asymptomatic or symptomatic, with trismus, limitation of mouth opening, and progressive malocclusion with facial asymmetry and can be painful. Aim: The aim of this paper is to report an unusual case of osteoma in the mandibular condylar neck and review the cases of mandibular condyle osteomas that have been reported in the last 15 years. Conclusions: Only a few cases involving the temporomandibular joint have been reported. We report an unusual case of osteoma in the mandibular condylar neck causing restricted mouth opening in addition to pain. Complete surgical excision in symptomatic cases is the therapy of choice with a low recurrence rate.
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Affiliation(s)
- Luisa Valente
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Riccardo Tieghi
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Stefano Mandrioli
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Manlio Galiè
- Department of Cranio-Maxillofacial Surgery, Unit of Cranio-Maxillofacial Surgery, University Hospital of Ferrara, Ferrara, Italy
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Central Osteoma of Maxilla Associated with an Impacted Tooth: Report of a Rare Case with Literature Review. Head Neck Pathol 2018; 13:554-561. [PMID: 30564996 PMCID: PMC6854353 DOI: 10.1007/s12105-018-0994-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 12/08/2018] [Indexed: 12/16/2022]
Abstract
Osteomas are benign osteogenic neoplasms caused by proliferation of mature compact or cancellous bone. Clinically they may be classified as peripheral, central or extraskeletal. Osteomas usually involve the craniofacial region with mandible being the most common site. Central osteoma of the jaws is a very rare entity with only 13 cases reported in the literature till date of which only five cases occurred in the maxilla. Here we present a case of a large central osteoma of anterior maxilla associated with an impacted tooth, the first of its kind and a review of literature.
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