Unusual Superolateral Dislocation of Bilateral Mandibular Condyles

We describe a case of maxillofacial trauma in a paediatric patient in which the left mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact and the right condyle was also displaced similarly but the zygomatic arch was also fractured on this side. Also, there was an associated mandibular symphyseal fracture.     

Superolateral Dislocation of Intact Mandibular Condyle: A Case Report and Review of Literature

Anteromedial fracture dislocation of the mandibular condyle is common but a superolateral dislocation of an intact condyle is quite rare. This type of dislocation is often misdiagnosed or completely overlooked and hence inadequately addressed. We report a case of a 41-year-old male patient who experienced superolateral dislocation of the intact condyle with symphysis fracture and panfacial fracture following a road-traffic accident, and review of literature of superolateral dislocations from 1967 to 2014.     

Superolateral Dislocation of the Mandibular Condyle: A Series of Seven Cases

Introduction

Anterior and anteromedial dislocations of the mandibular condyle are seen frequently in mandibular fractures. Less frequent are dislocations of the condylar head in the lateral, medial and posterior direction whereas superior dislocation into the middle cranial fossa is rare. We report a series of seven cases encountered over the years, which, incidentally, is the largest case series reported till date with lateral and superolateral dislocation of the condyle after a traumatic injury.

Materials and method

In all cases but one, the condyle was reduced by manual manipulation with the patient in general anaesthesia. In all cases but one there was simultaneous fracture in the mandibular symphyseal region. The associated fractures were reduced and fixed with bone plates and screws.

Results

Patients were generally free from any long term complications of injury or surgery except for facial nerve paresis of a transient nature in one case.

Conclusion

To our knowledge, this clinical series presents the first reported case of superolateral dislocation which required open reduction. The etiology and mechanism of dislocation has been discussed along with a brief review of the literature.

Electronic supplementary material

The online version of this article (doi:10.1007/s12663-015-0770-9) contains supplementary material, which is available to authorized users.     

Bilateral Bifid Mandibular Condyles

The bifid mandibular condyle is, in and of itself, a most uncommon anatomic occurrence. The observation of bilateral bifid mandibular condyles is, in fact, rare. Hrdlicka¹ first described three cases of this bilateral phenomenon in 1941 in the American Journal of Physical Anthropology. Since then, there have been no known reported cases of bilateral bifid mandibular condyles.

This paper reports a case of documented bilateral bifid mandibular condyles diagnosed in a young woman undergoing routine temporomandibular joint evaluation following a trauma to the face.     

Superolateral Dislocation of the Mandibular Condyle Not Associated With Fracture: A Case Report

Background  

Superolateral dislocation is rarely encountered in clinical practice. It is usually associated with fracture of the contralateral mandibular body or zygoma. The occurance of type II superolateral dislocation of the condyle without associated fracture is very rare and only a few cases are reported in literature.     

Bilateral Posterior Dislocation of Mandibular Condyle: A Rare Entity in Maxillofacial Injuries

BackgroundDislocation of the mandibular condylar head refers to ectopic positioning of the intact condylar head out of the glenoid fossa. Most commonly reported anterior dislocation results from anteromedial pull of the lateral pterygoid muscle and laxity of the surrounding tissue with advanced age.PurposeThis case report brings forth a unique case of bilateral posterior condylar dislocation in an edentulous patient who reported after 4 weeks of traumatic injury.MethodThe condition was managed surgically by reduction of the dislocated condyle and placement of mersilene tape on one side and temporalis muscle on the other side as anchorage ligament to stabilize the condyle and prevent any future recurrence.ResultsThe patient was maintained on long-term follow-up for up to one year with no reported recurrence or reduction in mouth opening.ConclusionThis is the first ever case report that highlights bilateral posterior dislocation of intact mandible unlike the previous four reports which have brought forth unilateral dislocation on English literature search. Posterior dislocation of mandibular condyle is encountered in edentulous patients who experience posteriorly directed impact which forces the condylar head behind the postarticular ridge. Unlike anterior dislocation, clinical features include reduced mouth opening and retruded mandible in bilateral dislocation. It has been observed that manual correction by pressing the mandible downwards and forwards yields good results in early cases. Cases that are reported late require surgical exploration for reduction and placement of anchorage ligament to prevent recurrence in unstable condyle.     

Bilateral Transmigration of Mandibular Canines: A Rare Occurrence

Transmigration is a phenomenon in which an unerupted tooth migrates and crosses the midline. Transmigration of the mandibular permanent canine is a rare phenomenon. We report a case of bilateral transmigrated mandibular canines, which presented as pain in the lower anterior teeth.     

Adolescent Mandibular Central Odontoameloblastoma: A Rare Case Report

Odontoameloblastoma is a rare odontogenic tumour, characterised by simultaneous occurrence of an ameloblastoma and a compound or complex odontoma in the same tumoral mass. The tumour is seen in first three decades and affects mandible or maxilla equally, commonly found posterior to the canines. The management is similar to unicystic ameloblastoma and odontoma excision. A long term follow up is a must to observe the recurrence. Here we present a rare case of odontoameloblastoma in a 17 year old male, presenting as an asymptomatic anterior mandibular swelling with chief complaint of missing lower front teeth.     

A Case of Impacted Supernumerary Fourth Molar in the Bilateral Mandibular Ramus

The occurrence of multiple supernumerary teeth in individuals without any associated syndrome is rare. In this report, a rare case of a 48-year-old woman who had an impacted supernumerary fourth molar in the bilateral mandibular ramus is described. She presented with a swelling in the left cheek region. Radiographic examination revealed an impacted supernumerary tooth in the left mandibular ramus with pericoronal resorption of the bone, suggesting peripheral inflammation. She also had an impacted supernumerary tooth on the right side. After administering an antibiotic and antiinflammatory drug, tooth extraction was performed under general anesthesia.     

Endodontic Microsurgery of Mandibular Second Molars Using the Bony Lid Approach: A Case Series

Endodontic microsurgery is important for preservation of natural teeth with symptomatic apical periodontitis when conventional endodontic treatment is neither feasible nor effective. The thick buccal cortex, poor visibility, and potential neurovascular complications can make microsurgical procedures of mandibular second molars infeasible. With the aid of cone-beam computed tomography, the bony lid approach was applied in 10 cases of endodontic microsurgery of mandibular second molars at the VIP Center, Hangzhou Stomatology Hospital between 2019 and 2020. In all cases, the clinical and radiographic findings at the 24- or 36-month follow-up revealed complete healing of the periapical lesions. The bony lid technique contributed to precise root-end localization and helped avoid excessive postoperative pain or unfavorable healing that occurred in cases of excessive alveolar bone resection. Some clinical tips on preserving the cortical bone, obtaining precise access, and improving surgical efficiency have been proposed in this report.     

Analysis of the Volumetric Asymmetry of the Mandibular Condyles Using CBCT

ObjectivesThe aim of this study was to analyse volumetric asymmetries between the right and left condyles in relation to age, gender, and dental status.Materials and methodsA retrospective analysis of 150 cone beam computed tomography (CBCT) scans was conducted. A single investigator performed the volumetric analysis of the CBCT scans using Vesalius 3D software. The volumetric data were analysed in relation to the gender, age, and dental status.ResultsThe mean right condylar volume was significantly higher (P < .01) than the left condylar volume. Right and left condylar volumes were significantly higher (P < .01) in male study participants when compared to female study participants. There was no significant difference (P = .47) in the volumetric asymmetry between the male and female study participants. The volumetric asymmetry was significantly higher (P < .01) in the older age groups when compared to the younger age groups. The volumetric asymmetry was significantly higher (P < .01) in the partially and completely edentulous patients when compared to the dentate study participants. The condylar volume on the side having a partially edentulous area was significantly lower than the condylar volume of the contralateral dentate side (P < .001).ConclusionsThe volumetric asymmetry between the right and left condyle significantly increases with age and edentulousness. The result of the study encourages the clinicians to perform volumetric evaluation of the condyles in cases of radiographically evident condylar asymmetries to obtain a more accurate diagnosis.     

Bilateral Calcifying Odontogenic Cyst: A Rare Entity

The calcifying odontogenic cyst (COC) accounts for 1 % of jaw cysts, found most commonly as central lesion. The COC usually manifests itself as a painless, slow growing swelling, anterior to the first molar region. Radiographically it appears as a well-defined, unilocular radiolucency, and may have a radiopaque mass in its center. Majority of the cases appear before the fourth decade of life. The COC is found rarely in patients in the first decade of life. Histopathological features include a cystic lining demonstrating characteristic “Ghost” epithelial cells with a propensity to calcify. Here we report the unusual occurrence of a case of 8 year child diagnosed with bilateral COC on right and left side of mandible.