Temporomandibular arthropathies: A retrospective study with histopathological characteristics.

BACKGROUND: To investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics. MATERIAL AND METHODS: Temporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included. RESULTS: The mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes. CONCLUSIONS: The pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named.

Changes in hemoglobin and hematocrit levels following orthognathic surgery of the mandible.

Red blood cell mass has been shown to recover rapidly with great decreases, as occurs in orthognathic surgery. However, blood loss during bilateral sagittal split osteotomy is considered minimal. The purpose of this study was to verify changes in hemoglobin (Hb) and hematocrit (Ht) levels following orthognathic surgery of the mandible. Data from 12 patients with a mean age of 27.5 years, from both genders, that were submitted to bilateral sagittal split osteotomy in the prognathism reduction were evaluated. No patient received blood transfusion during the procedure nor postoperatively. Procedures were performed by the same surgeon, with the use of reciprocating and sagittal saws. Levels of Hb and Ht were obtained in preoperative, one day postsurgery, and one, three and six weeks postoperatively. Statistical analyses were used to verify the difference in each group, and between periods. Patients lost a mean decrease in Hb of 2.0 g/dl, and in Ht of 5.2%. There was significant difference as to the levels of Hb (p=0.002) and Ht (p=0.010). These levels presented significant changes from immediate postoperative to six weeks for Hb, and to three weeks for Ht. It was concluded that a slow recovery of hemoglobin and hematocrit levels occurred following orthognathic surgery of the mandible.

Mineralization of stylohyoid ligament complex in patients with temporomandibular disorders and asymptomatic individuals: a comparative study.

The incidence of mineralization of the stylohyoid ligament complex, according to radiographic findings, was analysed in a group of patients with temporomandibular disorders (TMD), and compared with that of a control group of asymptomatic individuals (AI). Both groups were similar considering the prevalence of the female gender as well as the distribution of cases according to age. 'Elongated' was the most frequent radiographic appearance in both groups; 'partially mineralized' was the most frequent radiographic pattern in the TMD group; and the lower ramus was the most frequent location of mineralization in both groups. When comparing between groups and according to each class, there was only one significant difference in radiographic appearance, 'pseudoarticulated' being more frequent in the TMD group. We can conclude that the occurrence and characteristics of mineralization of stylohyoid ligament complex were similar in TMD patients and AIs.