Management of Intraoperative Contamination of the Custom Total Temporomandibular Joint Prosthesis.

Management of intraoperative contamination of a custom total temporomandibular joint prosthesis has not been reported in the literature. As this complication is rare, it can be unsettling for the surgeon. Improper management may lead to a complicated treatment course and financial consequences. Prevention is the primary strategy for avoidance and appropriate management is dependent on many variables. The purpose of this report is to identify a unique complication associated with placement of a custom temporomandibular joint prosthesis and offer an algorithm for management.

Artrocentesis en el tratamiento de artritis séptica en articulación temporomandibular: reporte de un caso / Arthrocentesis in the treatment of septic arthritis in the temporomandibular joint: a case report

Objetivo: El objetivo de este reporte de caso es presen- tar a la artrocentesis como una alternativa quirúrgica mínima- mente invasiva en el tratamiento de la artritis séptica tempo- romandibular. Caso clínico: Un paciente hombre de 26 años con an- tecedente de flegmón perimandibular derecho tratado, acude a la Unidad Hospitalaria de Cirugía Maxilofacial por dolor articular temporomandibular, impotencia funcional y trismus, a un mes de haber sido dado de alta de un primer cuadro infec- cioso. Luego de los exámenes clínicos y complementarios, se diagnostica artritis séptica de articulación temporomandibular derecha, la cual fue tratada quirúrgicamente mediante dos ar- trocentesis acompañadas de terapia farmacológica (AU)

Aim: The aim of this case report is to present arthrocen- tesis as a minimally invasive surgical alternative in the treat- ment of temporomandibular septic arthritis. Clinical case: A 26-year-old male patient, with a his- tory of treated right perimandibular phlegmon, came to the Maxillofacial Surgery Hospital Unit due to temporomandibu- lar joint pain, functional impairment and trismus, one month after having recovered from his first infectious process. After clinical and complementary examinations, septic arthritis of the right temporomandibular joint was diagnosed, which was treated surgically by means of two arthrocenteses and phar- macological therapy (AU)

Septic arthritis of the temporomandibular joint in an unvaccinated adolescent.

Septic arthritis of the temporomandibular joint (TMJ) is a rare condition, particularly in the paediatric population. Our case involves a 15-year-old unvaccinated Amish man with acute pain and trismus of the TMJ. The diagnosis was reached after history, clinical examination, radiographic and laboratory examinations were performed. The patient improved after a minimally invasive surgical procedure and medical therapy. Failure to recognise and treat septic arthritis in a timely fashion can result in serious sequalae. Infectious aetiologies should be kept on the differential for any patient with acute TMJ pain.

A Rare, Unusual Presentation of Primary Tuberculosis in the Temporomandibular Joint.

Tuberculosis (TB) is a very common health problem in developing nations such as India. It can present as its primary form or as secondary forms (extrapulmonary TB). Maxillofacial manifestations of TB compose nearly 10% of all extrapulmonary manifestations of the disease. Extrapulmonary TB involving the maxillofacial region is very rare and can present in any tissues in this region. These infections generally involve the head and neck through hematogenous or lymphatic routes. Very few cases of primary TB of the temporomandibular joint (TMJ) have been reported in the literature. The presentation of TB infection of the TMJ can resemble arthritis, osteomyelitis, or any other kind of chronic joint disease. It is very important to diagnose this disease at an early stage. If left untreated, it can prove fatal within 5 years in more than half the cases. Therefore, early diagnosis and management of these cases is critical. This article describes a case of primary TB of the TMJ that presented as a preauricular swelling.

A rare complication of tonsillitis: septic arthritis of the temporomandibular joint.

Septic arthritis of the temporomandibular joint (TMJ) is a rarely seen clinical condition. Such an infection may be encountered following infections in the head and neck region, with direct or haematogenous spread to the joint. This article presents the case of a patient with tonsillitis leading to septic arthritis of the TMJ and reports the results of a review of the literature.

Otogenic Temporomandibular Arthritis in Children.

Importance: Septic arthritis of the temporomandibular joint (SATMJ) is a very rare but potentially severe complication of pediatric middle ear infections because it presents risks of TMJ ankylosis. Objective: To describe the clinical, radiological, biological, and microbiological characteristics and evolution of SATMJ complicating middle ear infections (otogenic SATMJ) in children. Design, Setting, and Participants: This multicenter retrospective study included all children younger than 18 years referred between January 1, 2005, and December 31, 2015, for otogenic SATMJ or for TMJ ankylosis that occurred a few months to a few years after an acute mastoiditis. Nine children were included in the study. Review of the children's medical charts was conducted from February 1, 2016, to April 1, 2016. Main Outcomes and Measures: Patients' demographic characteristics and symptoms; radiological, biological, and bacteriological findings, including reanalysis of initial imaging; and treatment and outcome of SATMJ. Results: Of the 9 children, 6 were boys and 3 were girls; the mean age was 2.1 years (range, 6 months to 4.7 years). In 7 cases (78%), the primary middle ear infection was acute mastoiditis. Clinically, 5 children (55%) had preauricular swelling and only 1 (11%) had trismus. Associated thrombophlebitis of the lateral sinus or intracranial collections was present in 7 cases (78%). An initial computed tomographic scan was performed for all but 1 patient, and second-line analysis detected clear signs of TMJ inflammation in all 8 children who had a computed tomographic scan. However, SATMJ was diagnosed in only 3 cases at the time of the initial middle ear infection, leading to the recommendation of TMJ physical therapy for several months. The most frequently involved bacteria was Fusobacterium necrophorum, which was found in 4 cases. Long-term ankylosis was identified in 6 cases (67%), and 5 of these children required surgical treatment. Conclusions and Relevance: Clinicians and radiologists must thoroughly look for signs of SATMJ in children with acute mastoiditis to detect this complication, which can lead to disabling and hard-to-treat TMJ ankylosis.

Septic arthritis of the temporomandibular joint caused by rare bacteria Raoultella ornithinolytica.

Septic arthritis of the temporomandibular joint (TMJ) is an unusual disease in adults. Inoculation of the pathogen may occur through traumatic or iatrogenic injuries, or more often by haematogenous spread from a distant focus. The cause of infection is unknown in most cases. A case of ostensibly mild septic arthritis of the TMJ with a good response to antibiotic therapy and lavage, but that finally led to fatal destruction of the joint structures in a 38-year-old female patient, is reported herein. The infection was caused by Raoultella ornithinolytica - a rare bacterial species in humans, which has not been reported previously in any patients with joint problems. The arthritis manifested 5 weeks after an arthroscopy procedure, so the cause was not clear.

Temporomandibular Joint Septic Arthritis and Mandibular Osteomyelitis Arising From an Odontogenic Infection: A Case Report and Review of the Literature.

Septic arthritis of the temporomandibular joint (TMJ) has been infrequently reported in the literature. Some investigators believe that this condition is under-reported because it is underdiagnosed. Misdiagnosis or late diagnosis of this condition can lead to serious morbidity, including fistula formation, intracranial abscess, fibrous or bony ankylosis, temporal bone or condylar osteomyelitis, growth alteration, and several others. This report describes a case of septic TMJ arthritis arising from direct spread of an odontogenic infection with subsequent development of mandibular osteomyelitis. The purpose of this case report is to 1) increase awareness of an underdiagnosed condition, 2) establish the seriousness of this infection, 3) for the first time report on a case of TMJ septic arthritis caused by Bacteroides infection, and 4) provide a review of the relevant literature.

Reactive arthritis in relation to internal derangements of the temporomandibular joint: a case control study.

The aim of this study was to find out if reactive arthritis was involved in the aetiology of chronic closed lock of the temporomandibular joint (TMJ) by looking for bacterial antigens in the synovial membrane of the TMJ, and by studying the antibody serology and carriage of human leucocyte antigen (HLA) B27 in patients with chronic closed lock. Patients with reciprocal clicking and healthy subjects acted as controls. We studied a total of 43 consecutive patients, 15 with chronic closed lock, 13 with reciprocal clicking, and 15 healthy controls with no internal derangements of the TMJ. Venous blood samples were collected from all subjects for measurement of concentrations of HLA tissue antigen and serology against Chlamydia trachomatis, Yersinia enterocolitica, Salmonella spp., Campylobacter jejuni, and Mycoplasma pneumoniae. Samples of synovial tissue from patients with closed lock and reciprocal clicking were obtained during discectomy and divided into two pieces, the first of which was tested by strand displacement amplification for the presence of C trachomatis, and the second of which was analysed for the presence of species-specific bacterial DNA using 16s rRNA pan-polymerase chain reaction (PCR). There were no significant differences between the groups in the incidence of antibodies against M pneumoniae, Salmonella spp. or Y enterocolitica. No patient had antibodies towards C trachomatis or C jejuni. We found no bacterial DNA in the synovial fluid from any patient. The HLA B27 antigen was present in 2/15 subjects in both the closed lock and control groups, and none in the reciprocal clicking group. In conclusion, reactive arthritis does not seem to be the mechanism of internal derangement of the TMJ.

Microbiological investigation of retrodiscal tissues from patients with advanced internal derangement of the temporomandibular joint.

The aim of this study was to investigate the presence of bacteria in samples of retrodiscal tissues taken from patients suffering from advanced internal derangement of the temporomandibular joint (TMJ). 12 fresh retrodiscal tissue samples were taken from 12 consecutive patients who underwent unilateral TMJ discectomy for advanced TMJ internal derangement (Wilkes stage IV). The retrodiscal tissue samples were stained and cultured for the presence of micro-organisms in microbiology laboratories. No evidence of bacteria or other micro-organisms was found in any of the tissue specimens procured from the TMJ. This study failed to identify the presence of bacteria or other micro-organisms in fresh retrodiscal tissue specimens of the TMJ in patients with advanced TMJ internal derangement.

Case of tuberculosis of the temporomandibular joint.

Tuberculosis (TB) of the temporomandibular joint (TMJ) is rare and misdiagnosis is common. We describe an unusual case of the disease in a 27-year-old Zimbabwean woman.

Primary tuberculosis of the TMJ: presentation of a case and literature review.

Tuberculosis (TB) is a frequent health problem. The prevalence of extrapulmonary TB has increased in the last couple of years. Head and neck tuberculosis forms nearly 10% of all extrapulmonary manifestations of the disease. TB of the temporomandibular joint (TMJ) is rare; only a few cases have been reported. The clinical appearance of TB infection of the TMJ has been described as unspecific, resembling arthritis, osteomyelitis, cancer or any kind of chronic joint diseases. This article describes a 22-year-old woman with pain and left preauricular swelling. Magnetic resonance imaging and computed tomography showed an expansive process with destruction of the left condyle and condylar fossa. A fine needle aspiration examination of the swelling showed non-specific granulomatous inflammation. In the following days, a preauricular fistula developed, of which a swab and biopsy specimens were taken. Histological and microbiological examinations revealed an infection with Mycobacterium tuberculosis. The initial antituberculosis treatment consisted of a combination of four antibiotics and could be reduced to two antibiotics in the course of treatment. The treatment was completed successfully after 9 months.