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At least 1,207 records · Page 67Linked to original sources
PubMed1999

Diagnostic imaging of pigmented villonodular synovitis of the temporomandibular joint associated with condylar expansion.

Pigmented villonodular synovitis (PVNS) is a rare lesion of the temporomandibular joint. We report a case which was initially misdiagnosed as a parotid tumor. CT revealed a well-defined mass demonstrating higher attenuation than the adjacent soft tissue with marked expansion of the mandibular condyle. MRI clearly delineated the extent of the lesion which had very low signal intensity on both T1W and T2W sequences due to the effect of hemosiderin. The usefulness of these imaging procedures in diagnosis of PVNS is discussed.

Diagnosis, Differential↗
PubMed1978

Multiple myeloma involving the temporomandibular joint: report of case.

A case of multiple myeloma was reported in which the initial symptom was pain and dysfunction of the TMJ that resulted from pathological fracture of the mandibular condyle. An initial radiographic skeletal survey showed no evidence of further lesions, although hematological and biochemical tests indicated a diagnosis of multiple myeloma. Treatment resulted in improvement of symptoms and of an evident regression of the lesion after 18 months. After a year, however, radiographs disclosed generalized skeletal involvement; deterioration of the general condition followed.

Fractures, Spontaneous↗
PubMed1998

Orthodontic treatment of an adult male after bilateral condylectomy of the mandible for injuries sustained in a traffic accident.

In recent years there have been many reports on studies related to the temporomandibular joint (TMJ) in orthodontic treatment, but an adequate system of diagnosis and treatment has yet to be established, and they often cause considerable difficulty clinically. The patient in this case report sustained generalized contusions, a cerebral concussion, a midline fracture of the mandibular corpus, and bilateral fractures of the condylar process of the mandible when he fell asleep while driving a car and collided with a truck. Because non-surgical reduction was impossible, mandibular condylectomy was performed, and when orthodontic treatment was attempted to improve the open bite that persisted as a sequela of the accident, the favorable results were obtained, as described below. 1. The open bite was corrected by the orthodontic treatment, and the impairment that remained as a sequela resolved. 2. The mandibular condyles were removed during surgical reduction, and the mouth opening disturbance, the TMJ pain, and the TMJ noise resolved. The patient was able to go about his everyday life unimpaired, with hardly any awareness of limitation of jaw movement, and this situation remained unchanged even after the orthodontic treatment was performed.

Accidents, Traffic↗
PubMed1991

[Panoramic zonography in the diagnosis of TMJ fractures].

The radiological diagnosis of fractures of the mandibular condyle may be quite difficult. In a study of 237 patients the value of panoramic zonography is evaluated. Advantages of the new method are orthoradial projection, examination in a supine position, and good visibility of the anatomical structures in the TMJ-S and TMJ-PA program. Radiation doses in conventional radiography are 40-60 times higher than in panoramic zonography. High resolution CT should be reserved for special indications.

Humans↗
PubMed1977

Late effects of condylar irradiation in a child: review of the literature and report of case.

An unusual case in which hypertrophy of the mandibular condyle and hypoplasia of the maxilla and zygoma were observed in an 8-year-old child who had been irradiated at age 2 for malignant disease has been presented. Pertinent literature on the effect of irradiation of epiphyseal centers of growing bone has been reviewed. Consideration has been given to the possible mechanisms operative in producing the aberrations observed in this case, but the precise etiology remains obscure.

Child↗
PubMed2004

A case report of osteochondroma of the frontotemporosphenoidal suture.

Osteochondroma, also known as osteocartilaginous exostosis, is the most frequent benign bone tumour of the skeletal system. Despite its preference for long bones (tibia and femur), osteochondroma may occur in some short bones developing endochondral ossification. Seventy-five percent of the patients present only with a single lesion, whereas 25% have multiple lesions; this last clinical condition, defined as osteochondromatosis (disorder of autosomal dominant inheritance) shows a high risk of malignant transformation (about 11%). In the craniofacial area this tumour is very rare. The sites of predilection are the coronoid process and mandibular condyle, even though osteochondromas arising from the base of the skull, maxillary sinus and zygomatic arch have been previously described. However, an osteochondroma originating from the frontotemporosphenoidal suture has not been reported before in the literature. We present a unique case of osteochondroma of the frontotemporosphenoidal suture. Moreover, the relevant international literature has been reviewed and all diagnostic and surgical matters have been discussed.

Adult↗
PubMed1975

Radiologic examination of trismus as a complication of cancrum oris.

In the radiologic examination of trismus complicating cancrum oris, abnormalities can be detected in the soft tissues, osseous tissues, and temporomandibular joint. In the soft tissue, scar formation may show as a depression in the normal smooth, convex contour of the lateral aspect of the face. There may be a myositis ossificans in the soft tissue, producing bony bars that lead to extra-articular ankylosis. By far the most important changes are in the temporomandibular joint, where there can be varying degrees of joint narrowing, sclerosis of the articular cortex, flattening of the mandibular condyle and occasionally also of the eminentia articularis, osteophytosis, and intra-articular bony ankylosis. Hypoplasia may involve the entire hemimandible or be restricted to its condyloid process. The latter may lead to compensatory enlongation and hypertrophy of the coronoid process. Bony ankylosis of the coronoid process to the posterior wall of the maxilla was seen in three cases. The pathogenesis of these changes is discussed.

Adolescent↗
PubMed2002

Endoscopic fracture treatment.

Experience from TMJ arthroscopy and endoscopic sinus and skull base surgery has enabled oral and maxillofacial surgeons to use endoscopic assisted treatment in other operative fields. The endoscopic assisted management of maxillofacial trauma has been described for the treatment of fractures of the mandibular condyle, the zygomatic complex, the orbit and the frontal sinus. The operative management for open reduction and fixation of fractures by miniplate osteosynthesis has not changed. Using endoscopic assisted techniques limited incisions can be used and intraoperative control after fracture reduction in areas of limited exposure and visibility is possible. The indications for open treatment of maxillofacial trauma have not changed because of these endoscopic approaches.

Bone Plates↗
PubMed2007

A comparison of MRI, radiographic and clinical findings of the position of the TMJ articular disc following open treatment of condylar neck fractures.

We examined the position and function of the articular disc after open treatment of condylar fractures by comparing magnetic resonance images (MRI) and radiographs with clinical data. MRI and radiographs were taken after treatment of 28 patients with 33 fractures of the mandibular condyles. In all cases, the disc was located in the fossa after open reduction and internal fixation (ORIF). The MRI, radiographic and clinical findings did not correlate, and damage to the temporomandibular joint (TMJ) could be seen more clearly on MRI than on clinical or radiographic examination. Damage to soft tissues seen on MRI after treatment was more pronounced in dislocated than in displaced fractures.

Adult↗
PubMed1995

Cavernous sinus-carotid fistula: a complication of maxillofacial injury.

A case of traumatic carotid-cavernous sinus fistula (CCSF) is presented. The patient sustained an undisplaced fracture of his right mandibular condyle and a zygoma fracture after a motor vehicle accident. Five months later, all the classic signs and symptoms of a CCSF had appeared except ophthalmoplegia. These symptoms were preceded by a tiring auditive homolateral sensation. A carotid angiography confirmed the presence of a large CCSF. Successful management was achieved intravascularly by balloon embolization.

Accidents, Traffic↗
PubMed1993

Pediatric facial fractures: evolving patterns of treatment.

This study reviews the treatment of facial trauma between October 1986 and December 1990 at a major pediatric referral center. The mechanism of injury, location and pattern of facial fractures, pattern of facial injury, soft tissue injuries, and any associated injuries to other organ systems were recorded, and fracture management and perioperative complications reviewed. The study population consisted of 137 patients who sustained 318 facial fractures. Eighty-one patients (171 fractures) were seen in the acute stage, and 56 patients (147 fractures) were seen for reconstruction of a secondary deformity. Injuries in boys were more prevalent than in girls (63% versus 37%), and the 6- to 12-year cohort made up the largest group (42%). Most fractures resulted from traffic-related accidents (50%), falls (23%), or sports-related injuries (15%). Mandibular (34%) and orbital fractures (23%) predominated; fewer midfacial fractures (7%) were sustained than would be expected in a similar adult population. Three quarters of the patients with acute fractures required operative intervention. Closed reduction techniques with maxillomandibular fixation were frequently chosen for mandibular condyle fractures and open reduction techniques (35%) for other regions of the facial skeleton. When open reduction was indicated, plate-and-screw fixation was the preferred method of stabilization (65%). The long-term effects of the injuries and the treatment given on facial growth remain undetermined. Perioperative complication rates directly related to the surgery were low.

Accidents, Traffic↗
PubMed1985

Mandibular condylar structure and growth in Macaca fascicularis are related to skeletal rather than dentitional development.

Mandibular condyles of eight male monkeys (Macaca fascicularis), ranging in weight from 1.5 to 3.0 kg, were examined using histometric, radioautographic and stereologic techniques. The animals were classified on the basis of their dentitional and, as judged from radiographs of the hand and wrist, of their skeletal development. This allowed morphometric parameter means to be plotted as a function of four dentitional and five skeletal levels of maturation. The influence of dentitional and skeletal age on total parameter variations was examined by calculating factorial analyses of variance. Although consistent and well defined within each method, condylar parameter changes plotted over skeletal age were essentially different from those over dentitional age. Whereas the latter were difficult, if not impossible, to interpret, the former closely resembled the age-related curves displaying the elongation of short bones of the fingers in M. fascicularis. Furthermore these parameter changes were also consistent with longitudinal alterations in mandibular growth as assessed radiographically in man. The analyses of variance suggested that animals exhibiting the same degree of skeletal as compared to dentitional development, particularly at late stages of maturation, were markedly more homogeneous with respect to the majority of the morphometric parameters examined. Therefore, somatic maturation rather than the stage of tooth eruption should be the basis for estimating biological age in growth studies of the mandibular condyle.

Age Determination by Skeleton↗
PubMed1996

Computerized axiographic evaluation of condylar movements in cases with fractures of the condylar process: a follow up over 19 years.

The treatment of fractures of the mandibular condylar process(es) can be conservative or surgical. However, in many cases, a definitive judgment on the functional long-term outcome of the chosen therapy can only be given many years after the intervention. As a result, it is clearly useful to be able to review the effects of treatment undertaken at least 15 years previously. Even so, only two such studies have been identified. Therefore, the aim of the present study is to evaluate the current functional capacity of the mandibular condyles of 20 subjects who had had an uni- or bilateral fracture of the condylar process, on average 19 years ago. The individuals, who all had been treated conservatively, were compared with a control group of healthy volunteers matched for gender and age. Besides measuring maximum mouth opening (MMO), computerized axiographies in the sagittal plane were made for each condyle during MMO, maximum protrusion and maximum mediotrusion. In spite of the high degree of inter-individual variability in both groups, the data showed that the amount of condylar movement was in most cases greater in the control group. In general, it appears that the risk of developing functional problems after conservative treatment is highest in the case of a fracture of the condylar process accompanied by condylar luxation, rather than by a condylar dislocation or without it.

Adult↗
PubMed1993

Sequelae of unrecognized, untreated mandibular condylar fractures in the pediatric patient.

The mandibular condyle is a commonly involved site of maxillofacial trauma in children. However, this injury is often overlooked on initial physical examination in the emergency department. In cases involving blunt trauma to the chin it is important to suspect possible injury to the condyle of the mandible, as this type of facial injury can result in a spectrum of facial growth disturbances during the patient's later years. General practitioners and pediatric dentists are often the first clinicians to recognize the late complications of condylar trauma years after the injury. With a good clinical examination and past medical history, the diagnosis and etiology can be accurately determined. Once the diagnosis is made, the patient can be referred to a specialist involved in managing this type of problem. Three case reports of patients with facial deformity are presented.

Adolescent↗
PubMed1999

The value of coronal computer tomograms in fractures of the mandibular condylar process.

OBJECTIVE: A prospective investigation designed to compare the diagnostic accuracy of conventional panoramic and posteroanterior mandibular radiographs with that of coronal computed tomography scans in cases of fracture of the mandibular condylar process was conducted. STUDY DESIGN: In all, 182 patients with a total of 249 fractures (some unilateral and some bilateral) of the mandibular condyle received conventional radiographs and coronal computed tomography scans as diagnostic procedures. The ability of these procedures to detect and correctly classify these fractures was determined, and their importance for therapeutic decision-making is described. RESULTS: All clinically identified fractures were detected by means of both conventional and computed tomography imaging. However, only computed tomography scanning could correctly classify high condylar neck fractures. CONCLUSIONS: Especially in cases of high condylar neck fracture, coronal computed tomography scans were more useful than conventional radiographs in the determination of type of condylar fracture so that a correct treatment decision could be made.

Adolescent↗
PubMed1993

The compressible silicone rubber prosthesis in temporomandibular joint disease.

An alternative technique for temporomandibular joint arthroplasty is described, in which the mandibular condyle is replaced by a soft compressible silicone rubber prosthesis. A modified Nicolle-Calnan metacarpo-phalangeal joint prosthesis was used to reconstruct 31 joints in 24 patients. Results suggest that in those patients where there has been no loss of the prosthesis, function continues to be markedly improved when compared with the pre-operative condition. Painful symptoms were relieved in cases of specific joint pathology but the technique was of little value in the management of dysfunctional pain when radiographic evidence of joint pathology was absent. A specifically designed TMJ prosthesis of this type may be a useful addition to the surgeon's armamentarium.

Adolescent↗
PubMed1989

Comparisons in the treatment of facial trauma.

In 1980 a survey was conducted of the methods employed by OMF surgeons in the United Kingdom on the treatment of facial injuries. In 1986 a similar questionnaire was circulated in the UK with the addition of questions about clinical management. Towards the end of 1986 at a meeting in Amsterdam, arrangements were made for similar questionnaires to be circulated in The Netherlands, the USA and later in India and Hong Kong. The results recorded were as follows: UK: 164; The Netherlands: 94; USA: 1999; India: 20; Hong Kong: 5. This survey has revealed differences in the treatment of maxillofacial injuries in the countries concerned. There were differences in the means of fixation of fractured mandibles and in the types of anaesthesia used. The Americans were more likely to use extra oral surgical approaches for their lower border wirings or platings and were liable to operate on fractured mandibular condyles. The acceptability of patients being sent from the operating room with jaws wired together is confirmed by the fact that 95% of British and American OMF surgeons do this. The British OMF surgeons are much more likely to use fixation other than IMF in middle third injuries and are likely to use extra oral cranial fixation. Both the Dutch and the Americans are not so concerned about maxillary mobility and when they do employ fixation almost always use internal skeletal fixation. The approach to the reduction of a fractured malar is markedly different. The British are mainly using the Gillies approach, whereas the Dutch use the facial hook and the Americans a lower lid or brow approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

Unilateral condylar hyperplasia and the associated deformity of facial asymmetry. Case report.

The etiology of unilateral condylar hyperplasia is obscure. We believe that it is due more likely to an intra-uterine influence rather than to genetic disturbances. The disorder appears to have its basis in the cartilagenous growth centre of the mandibular condyle. The clinical picture varies a great deal, depending upon the onset of the growth upset relative to the age of the patient and the rate of growth. Two cases are reported. In one patient the anomalous growth pattern was apparent particularly in the condylar neck, which showed marked elongation, thickening and angulation. In the other patient the entire condyloid process appeared proportionately enlarged. The typical clinical history is one in which the patient had been aware for many years of progressive deviation of the jaw. Pain in the T.M.J. regions is rarely the presenting symptom. With recent advances of oral surgery, restoration of malocclusion and facial disharmony can be achieved by approaches other than the traditional procedure of condylectomy.

Adult↗