An exchange technique in temporomandibular joint (TMJ) arthroscopy to insert a larger operative cannula to facilitate advanced procedures.

The paper describes a modification of the surgical technique for temporomandibular joint arthroscopy, using an exchange guide to replace the 2.2 mm cannula with one of 2.9 mm to better facilitate osteoplasty of the medial wall. The procedure is a simple and safe manoeuvre that reduces complications such as fluid extravasation into soft tissues, damage to the articular eminence, and bleeding into the superior joint space. Every oral and maxillofacial surgeon could benefit from this novel method, which reduces the chances of failure when exchanging the working cannulas, the potential morbidity of re-entry, and the duration of surgery.

Innovative histological and histochemical characterization of tongue biopsies from patients with burning mouth syndrome.

OBJECTIVES: The present pilot study aims to perform an innovative histological and histochemical characterization of samples from patients with burning mouth syndrome (BMS) to correlate these findings with the clinical scenario. METHODS: To carry out this objective, the study samples were stained with the hematoxylin-eosin stain and later, an histochemical study was carried out to determine the composition of the extracellular matrix (ECM) using the stains of Alcian Blue, Picrosirius, Reticulin from Gomori and Verhoeff. RESULTS: The results of this study revealed histological patterns compatible with cellular hypertrophy in different layers of the epithelium as well as a greater keratinization in BMS cases. On the other hand, a lower amount of proteoglycans and a greater amount of collagen fibers were observed compared to the control. In addition, older patients had fewer reticular fibers and younger patients had fewer elastic fibers compared to the control. CONCLUSIONS: In conclusion, the present study shows the existence of a correlation between the histological patterns, age and symptoms of patients with BMS. Therefore, it is necessary to develop synergistic studies in order to assess and implement new classification systems that could improve the therapeutic approach of patients with BMS.

Histiocitosis de células de Langerhans con afectación maxilomandibular simultánea y rápida evolución simulando patología periodontal / Langerhans cell histiocytosis with simultaneous maxillomandibular involvement and rapid evolution mimicking periodontal pathology

La histiocitosis de células de Langerhans (HCL) es una enfermedad poco común con una tasa estimada de 1 caso por millón anualmente en adultos. En el sistema de clasificación actual, la HCL se clasifica según el grado de afectación de los órganos. Clínicamente, la cabeza y el cuello están afectados en casi el 90 % de los casos y pueden ser las únicas zonas afectadas. El maxilar y la mandíbula se ven afectados entre un 5 y un 10 % de los casos. En cuanto al diagnóstico, cuando se aprecia patología periodontal avanzada con movilidad dentaria y lesiones quísticas líticas en las pruebas de imagen, la HCL debe considerarse en el diagnóstico diferencial de dicha patología, pero el diagnóstico definitivo se realiza mediante estudio histológico e inmunohistoquímico. Presentamos un caso inusual de HCL que afecta simultáneamente al maxilar y a la mandíbula con una alta reabsorción ósea y patología periodontal de rápida evolución. Los síntomas que presentó la paciente simulaban patología periodontal y periapical. Tras analizar las muestras enviadas al servicio de anatomía patología, se diagnosticó HCL crónica y multifocal. El paciente fue tratado con legrado óseo, extracción dental y corticoides intralesionales. La HCL puede simular diferentes tipos de patologías periodontales que afectan al hueso maxilar o mandibular y estas deben ser diagnosticadas tempranamente mediante el envío de muestras al servicio de anatomía patológica. Además, es necesario realizar un correcto estudio de extensión porque su pronóstico cambia notablemente si afecta a varios órganos. (AU)

Langerhans cell histiocytosis (LCH) is a rare disease with an estimated rate of 1 case per million annually in adults. In the current classification system, LCH is classified according to the degree of organ involvement. Clinically, the head and neck are affected in almost 90 % of cases. The maxilla and mandibular are affected in 5 to 10 % of cases. Regarding diagnosis, when advanced periodontal pathology with tooth mobility and lytic cystic lesions is seen in imaging tests, LCH could be considered in the differential diagnosis, but the definitive diagnosis is made through histological and immunohistochemical study. We present an unusual case of LCH that simultaneously affects the maxilla and mandible with high bone resorption and rapidly evolving periodontal pathology. The symptoms presented by the patient simulated periodontal and periapical pathology. After analyzing the samples sent to the anatomopathology deparment, chronic and multifocal LCH was diagnosed. The patient was treated with bone curettage, dental extraction and intralesional corticosteroids infiltration. LCH can simulate different types of periodontal pathologies that affect the maxillary or mandibular bone and it must be diagnosed early by sending samples to the anatomopathology department. Furthermore, it is necessary to carry out a correct extension study because its prognosis changes significantly if it affects several organs. (AU)

Mandibular condyle dislocation into the middle cranial fossa with open reduction and reconstruction with glenoid fossa prosthesis. Unusual case report and literature review / Dislocación de cóndilo mandibular a fosa media craneal con reducción abierta y reconstrucción mediante prótesis de fosa glenoidea. Reporte de caso inusual y revisión de literatura

The dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) is a very infrequent lesion resulting from facial trauma. There is not consensus in which is the best way to treat this fractures, but the reduction of these impaction in the cranial middle fossa could be open or closed depending on the type of fracture and the experience of the surgeons. A case report of a 17 years old female with right condyle dislocation into the middle cranial fossa is presented, treated with open reduction and reconstruction with glenoid fossa prosthesis. (AU)

La luxación del cóndilo mandibular hacia la fosa craneal media (DMCCF) es una lesión muy poco frecuente secundaria a un traumatismo facial. No existe consenso sobre cuál es la mejor forma de tratar estas fracturas, pero la reducción de estas impactaciones en la fosa media craneal puede ser abierta o cerrada dependiendo del tipo de fractura y la experiencia de los cirujanos. Se presenta el caso de una mujer de 17 años con luxación de cóndilo derecho a fosa craneal media, tratada con reducción abierta y reconstrucción con prótesis de fosa glenoidea. (AU)