RESUMO
Metastasis of the oral cavity is a rare condition and should be investigated for a primary tumor in the lungs, breast, kidney and prostate. Involvement of the mandibular condyle frequently mimics TMJ dysfunction with pain, swelling and limitation of mouth opening. We report the case of atypic TMJ dislocation as an inaugural sign of condyle metastasis. We also discuss the diagnostic approach by a brief review of the literature.
Assuntos
Luxações Articulares , Neoplasias , Feminino , Humanos , Luxações Articulares/diagnóstico , Luxações Articulares/etiologia , Côndilo Mandibular , Pessoa de Meia-Idade , Neoplasias/complicações , Articulação TemporomandibularRESUMO
INTRODUCTION: Unilateral condylar hyperplasia (UCH) is characterized by an excessive growth of a mandibular condyle, resulting in facial, and occlusal deformities. Scintigraphic hyperactivity usually triggers the need of condylectomy. Delaire has presented a protocol for the treatment of active or non-active UCH using systematically a proportional condylectomy, which could solve both aetiology and adaptive deformities. The aim of this study was to evaluate this protocol by clinical and radiographical analysis. MATERIALS AND METHODS: Seventy-three patients with UCH were included in this retrospective study, and divided by clinical and cephalometric analysis in vertical, or transversal forms of UCH according to Delaire's classification. All patients were treated with 'proportional condylectomy', any indicated orthognathic procedures, along with maxilla-mandibular elastic therapy, and rehabilitation. Architectural, aesthetical, occlusal, and functional features were evaluated using clinical, cephalometric, and photographic measurements both preoperatively, and at the end of the follow-up. RESULTS: A female predominance was observed (65.8%). Vertical forms were more represented than transversal forms (61.6% versus 38.4%). There was a significant improvement of the occlusal plane, the posterior vertical excess, the chin deviation and the soft-tissue features (p < 0.0001), regardless of the preoperative scintigraphic activity status (p < 0.0001). The occlusion, and temporo-mandibular joint (TMJ) functions was considered as normal in respectively 72.7%, and 93% of the patients. CONCLUSION: The results of this study have demonstrated that a protocol using a 'proportional condylectomy', any indicated orthognathic techniques, maxilla-mandibular elastic therapy, and rehabilitation, is a reliable option for treating UCH, regardless the activity status of the pathology.
Assuntos
Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia , Adolescente , Adulto , Criança , Oclusão Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The purpose of this study was to analyse the demographics, causes and characteristics of maxillofacial fractures managed at several European departments of oral and maxillofacial surgery over one year. The following data were recorded: gender, age, aetiology, site of facial fractures, facial injury severity score, timing of intervention, length of hospital stay. Data for a total of 3396 patients (2655 males and 741 females) with 4155 fractures were recorded. The mean age differed from country to country, ranging between 29.9 and 43.9 years. Overall, the most frequent cause of injury was assault, which accounted for the injuries of 1309 patients; assaults and falls alternated as the most important aetiological factor in the various centres. The most frequently observed fracture involved the mandible with 1743 fractures, followed by orbital-zygomatic-maxillary (OZM) fractures. Condylar fractures were the most commonly observed mandibular fracture. The results of the EURMAT collaboration confirm the changing trend in maxillofacial trauma epidemiology in Europe, with trauma cases caused by assaults and falls now outnumbering those due to road traffic accidents. The progressive ageing of the European population, in addition to strict road and work legislation may have been responsible for this change. Men are still the most frequent victims of maxillofacial injuries.