RESUMO
ABSTRACT: Osteochondroma is a common benign bone tumor and although its involvement in facial bones is rare (0.6 %), it shows a strong predilection for developing in the mandibular condyle, causing occlusal changes and facial asymmetry. The aim of this study was to report a clinical case and the treatment of a 43-year-old male patient, who was diagnosed with condylar osteochondroma. Clinically, the patient presented an increase in volume in the right condylar region, deviation of the mandible to the left side and malocclusion. His main complaint was his facial asymmetry. Imaging exams showed changes in the size and morphology of the right condyle, and signs of hyper-capture on scintigraphy. The hypothesis of condylar hyperplasia and osteochondroma was raised. A virtual planning and execution of an orthognathic surgery of the jaws was performed to correct the occlusion and facial asymmetry, besides a low condylectomy to remove the lesion. Procedures such as high, low, proportional condylectomy, orthognathic surgery and TMJ reconstructive surgery are alternatives for the treatment of these pathologies. In our case, the orthognathic surgery combined with a condylectomy proved to be promising, to correct the occlusion and the facial asymmetry of the patient.
RESUMEN: El osteocondroma es un tumor óseo benigno común y aunque su afectación en los huesos faciales es rara (0,6 %), muestra una fuerte predilección por desarrollarse en el cóndilo mandibular, causando cambios oclusales y asimetría facial. El objetivo de este trabajo fue informar de un caso clínico y el tratamiento de un paciente de sexo masculino de 43 años, que fue diagnosticado con osteocondroma cóndilar. Clínicamente, el paciente presentaba un aumento en el volumen en la región condilar derecha, desviación de la mandíbula hacia el lado izquierdo y maloclusión. Su principal molestia era su asimetría facial. Los exámenes por imágenes mostraron cambios en el tamaño y la morfología del cóndilo derecho, y signos de hiper-captura en la centellografía. Se planteó la hipótesis de hiperplasia condilar y osteocondroma. Se realizó una planificación virtual y ejecución de una cirugía ortognática de la mandíbula para corregir la oclusión y la asimetría facial, además de una baja condilectomía para extirpar la lesión. Procedimientos como la condilectomía alta, baja y proporcional, la cirugía ortognática y la cirugía reconstructiva de la ATM son alternativas para el tratamiento de estas patologías. En nuestro caso, la combinación de la cirugía ortognática y una condiloectomía resultó ser prometedora, para corregir la oclusión y la asimetría facial del paciente.
RESUMO
Objective: This observational and retrospective study evaluated the prevalence and characteristics of odontogenic cysts, outlining the epidemiological profile of these lesions. Material and methods: The following data were collected from the medical records of patients with a diagnosis confirmed by microscopy: age, sex, ethnicity, anatomical location, histopathological diagnosis and treatment, between 1995 and 2018. Results: Of the 70 cysts, 75.7% were inflammatory and 24.2% development. The inflammatory periapical cyst was the most prevalent (62.8%) followed by the dentigerous cyst (71.0%). The lateral radicular cysts and odontogenic keratocysts obtained the same percentage (5.7%), followed by the residual cyst (4.3%), paradental (2.8%) and the orthokeratinized variable (1.5%). Women were slightly more affected (1.12: 1) with greater involvement of leucodermas (80%). Age and anatomical location differed according to each lesion, although the anterior maxilla region was more affected. Enucleation was the most used treatment (75.7%), except for odontogenic keratocysts, in which marsupialization was performed in 75% of the cases. Conclusion: Epidemiological data provide an important insight into the prevalence, extent and severity of these lesions, allowing early diagnosis and prevention, in order to guarantee the reduction of cases and improve the quality of life of the population.
Objetivo: Avaliar a prevalência e características dos cistos odontogênicos de forma observacional e retrospectiva, delineando o perfil epidemiológico destas lesões. Material e Métodos: Foram coletados os seguintes dados dos prontuários de pacientes com diagnóstico confirmado microscopicamente: idade, sexo, etnia, localização anatômica, diagnóstico histopatológico e tratamento, entre os anos de 1995 a 2018. Resultados: Dos 70 cistos, 75,7% eram inflamatórios e 24,2% de desenvolvimento. O cisto periapical inflamatório foi o mais prevalente (62,8%) seguido pelo cisto dentígero (71,0%). O cisto radicular lateral e queratocisto odontogênico obtiveram o mesmo percentual (5,7%), seguidos do cisto residual (4,3%), paradentário (2,8%) e a variável ortoqueratinizada (1,5%). As mulheres foram ligeiramente mais afetadas (1,12:1) com maior acometimento de leucodermas (80%). Idade e localização anatômica diferiram de acordo com cada lesão, embora a região anterior de maxila tenha sido mais afetada. A enucleação foi o tratamento mais utilizado (75,7%), exceto para o queratocisto odontogênico, no qual a marsupialização foi realizada em 75% dos casos. Conclusão: Os dados epidemiológicos fornecem uma visão importante para o entendimento da prevalência, extensão e gravidade dessas lesões, viabilizando o diagnóstico precoce e medidas preventivas, a fim de garantir a redução dos casos e melhorar a qualidade de vida da população.
