Computed tomography imaging findings of simultaneous bifid mandibular condyle and temporomandibular joint ankylosis: case report

Bifid mandibular condyle is an uncommon entity described in the literature as having a controversial etiology. Despite the absence of clinical symptomatology, the radiologist must be aware and should have some knowledge of this abnormality, as well its implications regarding functional and morphological changes. TMJ ankylosis is a disabling disease with involvement of the mandibular condyle, articular fossa and base of the skull. The association of bifid condyle with temporomandibular joint ankylosis is rare and must be carefully evaluated. The purpose of this paper is to report a case of simultaneous bifid mandibular condyle and temporomandibular joint ankylosis and to describe its computed tomography imaging findings.     

Chondrosarcoma of the mandibular condyle. Report of a case with special reference to radiographic features.

A case of chondrosarcoma of the mandibular condyle is described. With carefully taken tomographs, a diagnosis of chondrosarcoma of the mandibular condyle can be made with some degree of certainty, on radiological evidence alone. Chondrosarcomata of the mandibular condyle may manifest with the typical symptoms of the temporomandibular joint dysfunction syndrome. Tumours of the condyle can reach a large size without producing clinically obvious swellings. The literature pertaining to chondrosarcoma of the mandibular condyle is reviewed.     

Proposed radiographic protocol for central superior mandibular condyle dislocation into the middle cranial fossa: apropos of a case

Some difficulties have been described in the diagnosis of a number of reported cases of central superior mandibular condyle dislocation, which involves intracranial penetration of the mandibular condyle. Given that radiology plays an important role in detecting this condition, we herein propose an imaging diagnostic protocol for the management of suspicious superior mandibular condyle dislocation to identify this condition and properly evaluate the damaged tissues. We make reference to the case of a 13-year-old girl, who presented at the age of 7 years with a superior dislocation of the left condyle, which was clinically diagnosed as a probable temporomandibular joint ankylosis.     

Central luxation or dislocation of the mandibular condyle into the middle cranial fossa. A case report and review of the literature

This case report concerns a central luxation of the mandibular condyle of an 11-year-old girl. After a fall from a bicycle, the mandibular condyle luxated into the middle cranial fossa. The mandible was "ankylosed" in an ipsilateral latero-occlusion, and the diagnosis was confirmed by temporomandibular joint radiography. Immediate conservative reposition was performed successfully, without any immobilisation. After 18 months follow-up, the temporomandibular joint function was normal and painless despite progressive degenerative changes in the mandibular condyle. The patient's facial appearance proved to be normal.     

Condylar osteochondroma manifesting as Class III skeletal dysplasia: diagnosis and surgical approach

This is a case report of a 21-year-old man who had a gradually progressive Class III malocclusion and crepitation of the right temporomandibular joint. Routine TMJ tomograms revealed a radiopaque-radiolucent lesion of the right mandibular condyle with a compensatory anteroinferior displacement of the left mandibular condyle. Nuclear bone scans confirmed increased asymmetric technetium 99 tracer uptake in the region of the right temporomandibular joint. A two-stage surgical approach was undertaken; this consisted of excision of the condylar lesion to correct the Class III malocclusion and posterior crossbite and a LeFort I osteotomy to correct the slight transverse maxillary cant and anterior open bite. A histopathologic diagnosis confirmed osteochondroma of the mandibular condyle.     

Overgrowth of a costochondral graft in a case of temporomandibular joint ankylosis

Ankylosis of the temporomandibular joint (TMJ) involves fusion of the mandibular condyle to the base of the skull. When it occurs in a child, it can have devastating effects on the future growth and development of the jaws and teeth. Furthermore, in many cases, it has a profoundly negative influence on the psychosocial development of the patient because of the obvious facial deformity. Reconstruction of the mandibular condyle with costochondral grafts(CCGs) in children may result in overgrowth at the reconstructed side of the mandible. The growth pattern of the CCG is extremely unpredictable, and mandibular overgrowth on the grafted site can actually be more troublesome than the lack of growth. We report the case of a 3-year-old boy with temporomandibular ankylosis, which was treated with a CCG. The mandibular condyles and coronoid were resected unilaterally and immediately reconstructed with autogenous CCGs. He required one further resection because the grafted tissue had overgrown 5 years later.     

Myxoma of the mandibular condyle. A case report and review of the literature

Myxoma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction (TMD). The histogenesis, histologic profile, and management of myxoma of the jaws remain controversial. We report a case of myxoma involving the mandibular condyle appearing as TMD, and we review the literature to highlight current controversies surrounding this lesion.     

Trifid mandibular condyle: A case report

A few cases of bifid, but no case of trifid mandibular condyle, have been reported in the literature. This article presents the first reported case of trifid mandibular condyle in a living subject with a history of previous trauma to the temporomandibular joint (TMJ). Additionally, the patient's other condyle was bifid. The patient had no complaint related to the functions of TMJ except for minimal weakness following chewing. The etiology and the prognosis of bifid and trifid condyle are discussed briefly. We considered computed tomography essential to rule out early stages of TMJ pathology in similar cases that resemble trifid mandibular condyle on conventional radiographs.     

Osteochondroma of the mandibular condyle: a case report and review of the literature

Osteochondroma is rarely found in the oral and maxillofacial regions. A rare case of osteochondroma affecting the mandibular condyle of a 46-year-old Japanese woman is reported. Clinical examination revealed facial asymmetry, malocclusion, and a palpable hard mass in the right temporomandibular joint (TMJ). Radiologically, the lesion was visualized as a radiopaque mass in the same region, but no destructive features were evident. Three-dimensional computed tomography was employed for estimating the stereographic extension of the lesion, which seemed to develop from the anterior portion of the condylar neck, and extend to the condylar head. The patient underwent tumor excision and condyloplasty under a clinical diagnosis of benign TMJ tumor. The histopathological diagnosis was osteochondroma of the mandibular condyle, and the lesion consisted of proliferative bony and hyalinized cartilage-like tissues. Moreover, a cartilage cap, a characteristic feature of osteochondroma, was also observed. Thirty-eight cases of osteochondroma of the mandibular condyle described in the English literature, including the present case, were reviewed. The mean patient age was 39.7 years with a peak in the fourth decade, which was older than patients with tumors in the axial skeleton. There was no sexual predominance for tumors in either the mandibular condyle or axial skeleton. The histopathogenesis of this tumor developing in the mandibular condyle was also discussed.     

Avascular necrosis of the mandibular condyle causing fibrous ankylosis of the temporomandibular joint in sickle cell anemia

Avascular necrosis, which most commonly affects the femoral head, is a well-recognized entity in orthopedic surgery. Maxillofacial surgeons have recently recognized that a similar process may also be at work in the temporomandibular joint because of the involvement of the mandibular condyle. Avascular necrosis of the mandibular condyle in association with sickle cell anemia is an infrequent finding. In this report, a patient with avascular necrosis of the mandibular condyle in the late stage causing fibrous ankylosis of the temporomandibular joint in sickle cell anemia is presented.     

Chondroblastoma of the temporal bone involving the temporomandibular joint, mandibular condyle, and middle cranial fossa: case report and review of the literature

Chondroblastoma is a highly destructive tumor, derived from immature cartilage cells, typically occurring in epiphyses of the long bones of adolescents and young adults. Those occurring in the temporal bone and TMJ area are likely to mimic TMJ symptoms. This report describes a unique case in which a chondroblastoma resulted in extensive destruction of the temporal bone, temporomandibular joint, mandibular condyle, and cranial base, including gross intracranial and extracranial involvement. With appropriate surgical management, the outcome for patients with chondroblastoma of the temporomandibular region is quite favorable. This case brings the total reported chondroblastomas to 59 in the temporal bone and eight in the mandibular condyle as of the date of submission of this article for publication.     

Central giant-cell lesion in the mandibular condyle. Report of a case.

Giant-cell lesions of the temporomandibular joint are rare. In the present case a central giant-cell lesion of the temporomandibular joint is described, and the distinction between central giant-cell reparative granulomas and giant-cell tumors is discussed. Successful reconstruction of the temporomandibular joint by means of an 8 cm. costochondral graft in an elderly patient with a central giant-cell lesion of the mandibular condyle is also reported.     

Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint,Mandibular Condyle,and Middle Cranial Fossa: Case Report and Review of the Literature

Abstract

Chondroblastoma is a highly destructive tumor, derived from immature cartilage cells, typically occurring in epiphyses of the long bones of adolescents and young adults. Those occurring in the temporal bone and TMJ area are likely to mimic TMJ symptoms. This report describes a unique case in which a chondroblastoma resulted in extensive destruction of the temporal bone, temporomandibular joint, mandibular condyle, and cranial base, including gross intracranial and extracranial involvement. With appropriate surgical management, the outcome for patients with chondroblastoma of the temporomandibular region is quite favorable. This case brings the total reported chondroblastomas to 59 in the temporal bone and eight in the mandibular condyle as of the date of submission of this article for publication.     

Superolateral dislocation of the condyle: report of a rare case

Anterior dislocation of the mandibular condyle is commonly seen in patients with chronic dislocation of their temporomandibular joints. Posterior, superior and lateral dislocation is rare. Superolateral dislocation of an intact condyle, let alone intact mandible is uncommon, usually occurring after a traumatic insult to the mandible. The authors report on such a case, and its management.     

Posterior dislocation in intact mandibular condyle: an unusual case

Dislocation of the temporomandibular joint (TMJ) represents 3% of all reported dislocated joints. Traditionally, dislocation of the TMJ occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence. Traumatic dislocation of the condyle into the middle cranial fossa is well defined in the literature, but posterior dislocation without fracture is rarely described. This report documents a case of young male with posterior dislocation of the intact mandibular condyle after facial trauma. The clinical symptoms, diagnosis and treatment are discussed, and a critical review of the literature is provided.     

Bilateral anterosuperior dislocation of intact mandibular condyles in the temporal fossa

Dislocation of the temporomandibular joint occurs when the mandibular condyle is displaced anteriorly beyond the articular eminence and represents 3% of all dislocated joints reported in the body. Superolateral dislocation of the condyle into the temporal fossa is well documented in the literature, but anterosuperior dislocation without an associated fracture is rarely described. This report documents the case of a middle-aged woman with bilateral anterosuperior dislocation of the intact mandibular condyle after a fall on the face. This report reviews the literature on dislocations, suggests a nomenclature, possible causative mechanism and documents the importance of early management.     

髁突位置与颞下颌关节盘移位关系的研究

在颞下颌关节内紊乱（TMJID）的患者中髁突位置和关节盘移位之间的关系一直是研究者所关注的问题,许多学者从不同的角度进行了探索,但对TMJID患者髁突在关节窝中的位置及其临床意义存在争议。本文就TMJID概况、髁突位置与关节盘移位的关系及其在TMJID诊断中的意义作一综述。     

Radiographic changes of the temporomandibular joint after oblique sliding osteotomy of the mandibular rami

64 patients with mandibular prognathism were operated upon with oblique sliding osteotomies of the mandibular rami. The patients were followed with cephalometric and temporomandibular joint (TMJ) radiographs for 3 years. 60% of the TMJs showed skeletal remodelling 3 years postoperatively. The condylar remodelling was significantly correlated to the degree of postoperative displacement of the condyle. The average condyle displacement postoperatively was about 3 mm inferiorly and anteriorly, but the position was almost completely back to normal during the control period, due to a combination of reverse movement of the condyle and remodelling. Mandibular relapse was not correlated to postoperative displacement of the condyle or condylar remodelling. The range of condylar movement was unchanged at follow-up.     

Treatment of a case of skeletal class II malocclusion with temporomandibular joint disorder using miniscrew anchorage

At the present time, there are no reports in the literature on the treatment of temporomandibular joint disorder (TMD) by intrusion of molars using mini-screws. This case report describes the treatment for a female patient, aged 19 years seven months, with a TMD and an excessive lower anterior facial height. Overjet and overbite were +5.0 mm and +0.5 mm, respectively. The patient had a history of orthodontic treatment in which her first premolars were all extracted. During the first orthodontic treatment, a clockwise mandibular rotation was observed as a result of the increase of posterior dentoalveolar height. She had temporomandibular joint (TMJ) pain during mouth opening and complained of difficulty in eating due to masticatory dysfunction. The pretreatment Schuller views of both TMJ showed a posterior condyle position. In order to correct the overjet, molar relationship and the mandibular condyle position, a miniscrew was inserted into the palatal region of the upper first molar to intrude the upper posterior teeth. As the upper molars were intruded, the overjet was decreased, and a class I molar relationship was achieved by a counterclockwise mandibular rotation. After one year of treatment, an acceptable occlusion was achieved, and the condyle moved into centric position in the glenoid fossa. The patient's teeth continued to be stable, and she had no pain in TMJ after a retention period of three years. The result of this treatment showed that molar intrusion using miniscrew anchorage is effective for treatment of a TMD patient with a posterior condyle position.     

Use of conservative condylectomy for treatment of osteochondroma of the mandibular condyle.

PURPOSE: The aim of the present study was to present a conservative condylectomy technique (condylectomy performed below the condylar head but high in the condylar neck) and articular disc repositioning as the surgical treatment approach for management of osteochondroma of the head of the mandibular condyle. PATIENTS AND METHODS: Six patients (4 females and 2 males) with an average age of 22.3 years (range, 13 to 32 years) and with an osteochondroma of the mandibular condyle were treated with conservative condylectomy. The remaining condylar neck stump was recontoured, and the articular disc was repositioned and stabilized over the "new" condyle. Any indicated orthognathic surgical procedures were then performed to optimize occlusion, function, and aesthetics. Clinical and radiographic evaluation was performed before surgery (T1), immediately after surgery (T2), and at the longest follow-up (T3). RESULTS: Average follow-up for the patients was 51 months (range, 22 to 108 months). No recurrence of the tumor was encountered in any of the cases. Subjective and objective evaluations of postsurgical temporomandibular joint function and range of mandibular motion were normal. Associated maxillary and/or mandibular orthognathic procedures were found to be stable in the long term. CONCLUSION: Conservative condylectomy with recontouring of the residual condylar neck to function as a condyle and repositioning of the articular disc is a viable option for treatment of osteochondromas of the mandibular condyle. The use of this method of treatment permits effective removal of the tumor and eliminates the need for autogenous grafts or total joint prostheses for temporomandibular joint reconstruction.