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Indian Journal of Dental Research :... Oct 2023Ossifying fibromas are rare, non-aggressive benign tumours of the bone, commonly involving the posterior mandible in middle-aged individuals with a female predilection.
INTRODUCTION
Ossifying fibromas are rare, non-aggressive benign tumours of the bone, commonly involving the posterior mandible in middle-aged individuals with a female predilection.
FINDINGS
Clinical manifestations include asymptomatic expansion of the mandible with infrequent maxillary lesions, pain, malocclusion, and compromised quality of life including aesthetic perception. Owing to multiplicity of features, tendency of recurrence, and possibility of malignant transformation, the diagnosis, treatment, and post-operative management of ossifying fibroma are always a challenge.
TAKEAWAY LESSONS
Study aims to report a clinical case of extensive swelling involving the coronoid process and condyle on the right side to crossing the mid-line of the mandible with compromised functions and aesthetics. The article describes the clinical, histopathological, and radiological features of the case. The possible treatment and challenges encountered are discussed.
Topics: Humans; Fibroma, Ossifying; Mandibular Neoplasms; Female; Radiography, Panoramic; Adult
PubMed: 38739833
DOI: 10.4103/ijdr.ijdr_134_21 -
Journal of Personalized Medicine Jul 2023The purpose of this study is to report clinical and instrumental changes after RA.DI.CA splint therapy for temporomandibular joint disc displacement without reduction.
BACKGROUND
The purpose of this study is to report clinical and instrumental changes after RA.DI.CA splint therapy for temporomandibular joint disc displacement without reduction.
METHODS
Subjects affected by disc dislocation without reduction were recruited between July 2020 and May 2022 based on inclusion and exclusion criteria and treated with RA.DI.CA. splints over a period of 6 months. Clinical data were collected at each phase of the study (T0, T1, T2). Magnetic resonance imaging and electrognathography data were recorded at the beginning (T0) and at the end (T2) of the study. ANOVA with post-hoc contrasts was performed to assess differences in outcome measures over time. The Wilcoxon test was used to evaluate changes in disc-condyle angle between before- and after-treatment MRI. A two-tailed value of < 0.05 was regarded as significant.
METHODS
Ten patients completed the study. There were statistically significant differences over time for arthralgia, headache, neck pain, and mouth opening. Disc recapture and an improved quality of mandibular movement were recorded in 70% of subjects. The clinical and instrumental improvements are probably due to the orthopedic action of RA.DI.CA splint treatment, which allows for a greater degree of joint mobilization.
CONCLUSIONS
The purpose of this therapy is to recover the disc position if possible and achieve an adequate joint functional adaptation that avoids the progression of the structural damage and the recurrence of symptoms.
PubMed: 37511708
DOI: 10.3390/jpm13071095 -
American Journal of Orthodontics and... Aug 2023Transdifferentiation of chondrocytes into bone cells explains most of the prenatal and early postnatal condylar growth, but its role during later postnatal growth and...
INTRODUCTION
Transdifferentiation of chondrocytes into bone cells explains most of the prenatal and early postnatal condylar growth, but its role during later postnatal growth and the mechanisms regulating transdifferentiation remain unknown. This study aimed to quantify the effects of mechanical loading on chondrocyte-derived osteogenesis during late postnatal condylar growth using a short-term mandibular laterotrusion model.
METHODS
Thirty 4-week-old Aggrecan-Cre, R26R, and 2.3Col1a1-GFP compound mice received tamoxifen injections and were divided into control and experimental groups. Appliances were bonded to shift the mandibles of the experimental mice for 5 days, causing protrusion and retrusion of the right and left condyles, respectively. Radiographic, microcomputed tomographic, and histomorphometric analyses were performed.
RESULTS
The experimental and control groups showed substantial transdifferentiation of chondrocytes into bone cells. The experimental mice developed asymmetric mandibles, with the protrusive side significantly longer than the retrusive side. The protrusive condyles showed significantly increased chondrogenesis and greater numbers of chondrocyte-derived osteogenic cells, especially in the posterior third. The opposite effects were seen on the retrusive side.
CONCLUSIONS
Transdifferentiation of chondrocytes into bone cells occurs during late postnatal condylar growth. Laterotrusion regulates condylar chondrogenesis and chondrocyte transdifferentiation, which alters the amount and direction of condylar growth. Our study demonstrated that chondrocytes are key players in condylar bone formation and should be the focus of studies to control and further understand condylar growth.
Topics: Pregnancy; Female; Mice; Animals; Chondrocytes; Mandibular Condyle; Cell Transdifferentiation; Osteogenesis; Mandible
PubMed: 36922241
DOI: 10.1016/j.ajodo.2022.12.011 -
BMC Oral Health Jan 2024The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam...
BACKGROUND
The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT).
METHODS
Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment.
RESULTS
Height of condylar head increase significant (P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head (P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably (P < .05). No significant difference was detected in other values ((P > .05).
CONCLUSION
Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.
Topics: Adult; Humans; Bone Density; Cone-Beam Computed Tomography; Dental Care; Malocclusion, Angle Class II; Bone and Bones
PubMed: 38191341
DOI: 10.1186/s12903-023-03728-y -
Current Opinion in Otolaryngology &... Apr 2024This review aims to describe the oncological outcomes of T4b oral squamous cell carcinomas (OSCC) with masticatory space involvement as well as the surgical approaches... (Review)
Review
PURPOSE OF REVIEW
This review aims to describe the oncological outcomes of T4b oral squamous cell carcinomas (OSCC) with masticatory space involvement as well as the surgical approaches that are able to achieve compartmental 'en bloc' resection of these lesions.
RECENT FINDINGS
The masticatory space is subdivided into infra-notch and supra-notch spaces according to the axial plane passing through the mandibular notch between the coronoid process and the condyle neck. Compartmental resection for T4b OSCC with masticatory space invasion can be successfully achieved via purely external approaches or combining external and transnasal endoscopic routes. Infra-notch T4b OSCC showed survival outcomes comparable to T4a OSCC, thus prompting treatment with curative intent.
SUMMARY
Compartmental resection of the masticatory space is technically feasible with comprehensive control of tumour margins. Use of a transnasal endoscopic anterior route within a multiportal approach may provide better control of margins at the level of the pterygo-maxillary fissure. Equivalent survival outcomes between T4a and infra-notch T4b OSCC are reported. Thus, a downstaging of the latter to T4a is advisable and compartmental surgery of such advanced lesions could be considered as a first-line treatment option in selected patients.
Topics: Humans; Mouth Neoplasms; Squamous Cell Carcinoma of Head and Neck; Carcinoma, Squamous Cell; Head and Neck Neoplasms
PubMed: 38193497
DOI: 10.1097/MOO.0000000000000958 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Aug 2023To investigate the relationship between idiopathic condylar resorption (ICR) and arch width disorder. Thirty-two patients with ICR and twenty patients without...
To investigate the relationship between idiopathic condylar resorption (ICR) and arch width disorder. Thirty-two patients with ICR and twenty patients without condylar resorption were enrolled according to the same inclusion criteria. They were divided into experimental group and control group. The experimental group was divided into unilateral ICR group and bilateral ICR group according to the affected side of condylar resorption, and then experimental group was divided into subgroups ICR Ⅰ, ICRⅡand ICR Ⅲ according to the degree of condylar resorption. Patients with no condylar resorption were used as a control group. The width of anterior, middle and posterior segments of dental arch on cone beam computed tomography(CBCT) was measured and the two groups of measured values were statistically analyzed. Compared with the control group, the width of maxillary anterior, middle and posterior segments in ICR group was significantly reduced, and the difference was statistically significant(<0.01). But the width of mandibular segment was not significantly different from that in control group(>0.05). There was no significant difference in the width of anterior, middle and posterior dental arch between subgroups(>0.05). Almost all patients with ICR have malocclusion of maxillary and mandibular arch width, but there is no significant correlation between the malocclusion width and the severity of condylar resorption.
Topics: Humans; Mandibular Condyle; Dental Arch; Bone Resorption; Mandible; Malocclusion
PubMed: 37551574
DOI: 10.13201/j.issn.2096-7993.2023.08.010 -
Forensic Sciences Research Sep 2023The establishment of anthropometric measurements is of fundamental importance for the correct identification of human bodies. The objective of this study was to evaluate...
The establishment of anthropometric measurements is of fundamental importance for the correct identification of human bodies. The objective of this study was to evaluate the accuracy and reliability of two-dimensional craniometric landmarks obtained from three-dimensional cone beam computed tomography reconstructions for forensic identification of humans. Computed tomography images with voxel sizes of 0.25, 0.3, and 0.4 mm were obtained using i-CAT® three-dimensional equipment. Ten landmarks were randomly selected, and 10 measurements were demarcated in the three-dimensional reconstruction to evaluate the mandibular condyle, ramus, and body. This study demonstrated that protocols with voxels of 0.3 mm should be preferentially indicated for the evaluation of linear and angular measurements. Implementing our methodology using prototypes for clinical and forensic simulations allows comparisons with human databases in identification issues.
PubMed: 38221974
DOI: 10.1093/fsr/owad029 -
BMC Oral Health Oct 2023Osseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role...
BACKGROUND
Osseous changes of the temporomandibular joint (TMJ) are related to the progression of temporomandibular disorders (TMD), and computed tomography (CT) plays a vital role in disease evaluation.
OBJECTIVE
The aims of this study were to evaluate the image quality and diagnostic value of ultra-high-resolution CT (U-HRCT) in TMD compared to cone-beam CT (CBCT).
METHODS
TMD patients who underwent both CBCT and U-HRCT between November 2021 and September 2022 were retrospectively included. Image quality scores were assigned for four osseous structures (the cortical and trabecular bones of the condyle, articular eminence, and glenoid fossa) by two independent observers from Score 1 (unacceptable) to Score 5 (excellent). Diagnostic classification of TMD was categorized as follows: Class A (no evident lesion), Class B (indeterminate condition) and Class C (definitive lesion). Image quality scores and diagnostic classifications were compared between CBCT and U-HRCT. The Cohen's Kappa test, Wilcoxon signed-rank test, Chi-square test and Fisher's exact test were conducted for statistical analysis.
RESULTS
Thirty TMD patients (median age, 30 years; interquartile range, 26-43 years; 25 females) with 60 TMJs were enrolled. Image quality scores were higher for U-HRCT than for CBCT by both observers (all Ps < 0.001). Definitive diagnoses (Class A and C) were achieved in more cases with U-HRCT than with CBCT (93.3% vs. 65.0%, Fisher's exact value = 7.959, P = 0.012). Among the 21 cases which were ambiguously diagnosed (Class B) by CBCT, definitive diagnosis was achieved for 17 cases (81.0%) using U-HRCT.
CONCLUSIONS
U-HRCT can identify osseous changes in TMD, providing improved image quality and a more definitive diagnosis, which makes it a feasible diagnostic imaging method for TMD.
Topics: Female; Humans; Adult; Retrospective Studies; Temporomandibular Joint; Temporomandibular Joint Disorders; Tomography, X-Ray Computed; Mandibular Condyle; Cone-Beam Computed Tomography
PubMed: 37814269
DOI: 10.1186/s12903-023-03449-2 -
Eplasty 2024Ameloblastoma is a rare odontogenic tumor most commonly located within the mandible. These tumors can grow to massive proportions and result in malocclusion. Segmental...
BACKGROUND
Ameloblastoma is a rare odontogenic tumor most commonly located within the mandible. These tumors can grow to massive proportions and result in malocclusion. Segmental mandibulectomy and reconstruction with an osteocutaneous free flap are frequently required. Virtual surgical planning (VSP) aids the surgeon in creating precise anatomic reconstruction when there is preoperative malocclusion due to tumor size. In this study we seek to further examine reconstruction of posterior mandibulectomy defects inclusive of condylar resection.
METHODS
Retrospective review of patients treated for giant ameloblastoma (tumor >4 cm) was examined; 3 patients with posterior tumors requiring ramus and condylar resection were included. Reconstruction in all patients was performed using fibula free flaps and VSP custom-made mandibular reconstruction plates. In these patients the reconstructed ramus was shortened and precise contouring done with a burr to recreate the native condylar surface. Intermaxillary fixation was used to maintain occlusion for 1 month postoperatively. Inferior alveolar nerve repair with allograft and nerve connectors was performed for all 3 patients.
RESULTS
All patients underwent successful mandibular reconstruction with preservation of mandibular function and improved occlusion postoperatively. Inferior alveolar nerve repair using nerve allograft allowed for neurosensory recovery in the mandibular division of trigeminal nerve distribution in 2 of the 3 patients.
CONCLUSIONS
Giant ameloblastoma involving the mandibular condyle can be successfully treated with the fibula free flap utilizing mandible reconstruction plates and VSP. This technique allows for excellent restoration of occlusion and neurosensory recovery when paired with reconstruction of the inferior alveolar nerve at time of reconstruction.
PubMed: 38476514
DOI: No ID Found -
Dental Research Journal 2023Horizontal condylar guidance (HCG) is registered by protrusive interocclusal records but in nonarcon articulators, these records can affect the accuracy. The present...
BACKGROUND
Horizontal condylar guidance (HCG) is registered by protrusive interocclusal records but in nonarcon articulators, these records can affect the accuracy. The present study aimed to evaluate the effect of a novel rotation coordinating device (RCD) on condylar guidance setting with protrusive interocclusal records.
MATERIALS AND METHODS
The study was designed as a comparative investigation. Stone maxillary and mandibular casts were mounted on a fully adjustable instrument as the patient. Duplicate casts were mounted on an arcon and a nonarcon articulator with corresponding face bow records and in maximum intercuspation relation. Five different condylar guidance inclinations for both sides (20°, 30°, 40°, 50°, and 60°) were set on the fully adjustable instrument and 16 protrusive interocclusal records were established at each setting. HCG was set for arcon, nonarcon articulators, and nonarcon articulators with RCD. Data were analyzed using one-sample -test to compare with actual HCG and one-way analysis of variance ( =0.05).
RESULTS
Mean HCG for studied articulators was 35.40 for arcon, 30.31 for nonarcon without RCD, and 35.61 for nonarcon with RCD which were significantly different from actual HCG ( < 0.05). HCG of the nonarcon with RCD showed no significant difference with arcon articulator ( = 0.71) while both were significantly different from nonarcon without RCD ( < 0.001).
CONCLUSION
"The RCD" compensates the condylar guidance inclination difference between arcon and nonarcon articulators. The device precisely transfers the hinge movement of the upper member of the articulator to the condylar track.
PubMed: 38020259
DOI: No ID Found