1/24. arthrogryposis multiplex congenita in a patient with limited mouth opening: a case report.This report describes a case of arthrogryposis multiplex congenita and concomitant bruxism with limited mouth opening and pain in the temporomandibular joints (TMJ). A conservative treatment with a myorelaxing splint and physiotherapeutic exercises was prescribed resulting in improvement to the muscular and joint conditions and a reduction in pain.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/24. Condylar hyperplasia associated to synovial chondromatosis of the temporomandibular joint: a case report.Condylar hyperplasia is a slowly developing malformation of the mandible, with elongation of the mandibular neck, that generally results in facial asymmetry. Synovial chondromatosis is a benign chronic disorder characterized by the formation of multiple small nodules of hyaline cartilage as a result of metaplasia of the synovial connective tissue. It affects mostly the large joints, particularly the knee, hip, elbow and ankle. The temporomandibular joint (TMJ) is rarely affected. The case of a 42-year-old male with a history of left preauricular pain and swelling and deviation of the mandible to the left upon opening the mouth is presented. Computed tomography disclosed hyperplasia of the left condyle with loose radiopaque bodies within the joint cavity. The left TMJ was subject to open surgery, which included resection of four loose bodies and a remodeling condylectomy. The histopathological study confirmed the diagnosis of condylar hyperplasia and chondromatosis of the left TMJ.- - - - - - - - - - ranking = 0.20307172828332keywords = mouth, cavity (Clic here for more details about this article) |
3/24. Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction.temporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
4/24. Microvascular temporomandibular joint and mandibular ramus reconstruction in hemifacial microsomia.Microvascular temporomandibular joint (TMJ) and mandibular ramus reconstruction was performed in a 4-year-old hemifacial microsomia patient with multiple craniofacial and extracranial anomalies (goldenhar syndrome). Her major craniofacial anomalies included bilateral cleft lip and palate, left macrostomia, left microtia, and complete absence of the left vertical mandibular ramus and TMJ. Most of her other anomalies had been corrected surgically before TMJ and vertical mandibular ramus reconstruction, which was accomplished with a metatarsophalangeal (MTP) joint transplantation. The MTP joint was placed in hyperextended position in the skull base inserting the proximal phalanx under the remnants of the zygomatic arch and replacing the vertical mandibular ramus with the metatarsal bone. Straight mouth opening, correction of the midline, and normalized lateral movements of the mandible were accomplished. The graft includes two epiphyseal plates, which should maintain growth of the transplant. During the follow-up period (16 months) the achieved results have been maintained without adverse effects. The present technique appears to be a promising alternative in the treatment of children with Pruzansky type 3 hemifacial microsomia.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
5/24. Asymmetric crying facies associated with hemihypertrophy: report of one case.An infant whose face appears symmetrical at rest yet whose mouth is pulled downward to one side when crying is said to have an "asymmetric crying facies". The cause of the facial asymmetry in this disorder is congenital absence or hypoplasia of the depressor anguli oris muscle at the corner of the mouth. Associations of this minor facial defect with major congenital anomalies have been reported, most commonly in the cardiovascular system and less frequently involving the genitourinary, musculoskeletal, cervicofacial, respiratory, and, rarely, the central nervous system. In this article, a 40-day-old boy with asymmetric crying facies associated with malformed right ear, patent foramen ovale, hemivertebrae, thoracic scoliosis, and hemihypertrophy is presented. The last anomaly has not previously been published in association with asymmetric crying facies in the literature according to our knowledge.- - - - - - - - - - ranking = 0.4keywords = mouth (Clic here for more details about this article) |
6/24. Mandibular distraction osteogenesis using an intraoral device and bite plate for a case of hemifacial microsomia.OBJECTIVE: To present orthodontic treatment combined with mandibular distraction osteogenesis using an intraoral device and a bite plate in a patient with hemifacial microsomia, severe facial asymmetry, and unilateral mandibular hypoplasia. PATIENT: An 8-year-old girl exhibited mandibular deviation resulting from hypoplasia of the mandibular condyle and ramus on the left side. The patient was treated with an intraoral device for mandibular distraction osteogenesis, bite plate, and hybrid-type functional appliance. facial asymmetry was improved, and the mandibular ramus was elongated in an anterior and primarily posterior direction with slightly posterior and superior displacement of the proximal segment. Postdistraction treatment results have been stable for 1 year. At the 1-year follow-up, the volume of the lateral and medial pterygoid muscles on the left side had increased. The condyle and disc on the right temporomandibular joint moved well and in harmony at open mouth position, and a rotational movement of the left temporomandibular joint was observed.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
7/24. Simultaneous orbital expansion and intraoral distraction osteogenesis of upper and lower jaws in a patient with hemifacial microsomia.BACKGROUND: Correction of a micro-orbit, caused by clinical anophthalmia is a very challenging task. In hemifacial microsomia a micro-orbit may be combined with hypoplasia of the malar and the ascending mandibular ramus. MATERIAL: A 5-year-old patient with hemifacial microsomia is described. Hypoplasia of the malar bone and the tilted occlusal plane were corrected by means of intraoral distraction osteogenesis in the upper jaw following precise simulation surgery on a 3D-model. At the same time, the ascending mandibular ramus was lengthened with a second distraction device and a spherical tissue expander was inserted into the hypoplastic orbit. RESULTS: The malar as well as upper and lower jaws were lengthened and positioned symmetrically. The orbital cavity was expanded to 79% of that of the healthy side. Following removal of the distraction devices, the expander was exchanged for a larger one and orbital expansion was continued until overcorrection of the orbit up to 118 percent was achieved. CONCLUSION: Orbital expansion is a minimally invasive method of enlarging the volume of the eye socket three-dimensionally. Intraorally activated buried distraction devices enable "growth" of the jaws making bone transplants avoidable in many cases. By combining both methods, complex malformations can be corrected simultaneously in children.- - - - - - - - - - ranking = 0.0030717282833193keywords = cavity (Clic here for more details about this article) |
8/24. Orthopedically induced condylar growth in a patient with hemifacial microsomia.OBJECTIVE: Hemifacial microsomia is a congenital abnormality that causes three-dimensional facial asymmetry, affection of the dental occlusion, and failure of growth of the midface in the growing child. This report outlines orthopedically induced condylar growth in a patient with hemifacial microsomia. PATIENT: A 7-year-old girl with hemifacial microsomia, complete absence of the left mandibular condyle, and severe facial asymmetry was treated orthopedically in an early stage by means of a functional appliance. Functional therapy was instituted to stretch the deficient soft tissues to guide and promote skeletal growth and stimulate the affected areas. The treatment was completed with fixed appliances. RESULTS: The effect of the therapy was an excessive change in condylar growth in the affected side. facial asymmetry was corrected and a symmetric mouth opening was established. CONCLUSIONS: The treatment of patients with hemifacial microsomia should be initiated early enough so that the stimulus could in some degree normalize the deficient tissues and induce bone apposition, and in some cases surgical intervention could be avoided.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
9/24. Serial observation of asymmetry in the growing face.Three children suffering from facial asymmetry were observed annually using facial stereophotogrammetry before, during, and after their general skeletal adolescent growth spurt. Stereophotogrammetry allows accurate three-dimensional measurements between identifiable facial landmarks. Five pairs of bilateral parameters connecting external canthi and angles of the mouth to alae and tip of nose, and to each other, allowed a positive sign (right-side larger) or a negative (left-side larger) assessment of parameter asymmetry. Their total, taking sign into account, assessed mid-facial asymmetry. Serial observation showed that: (1) in patient no. 1 suffering from post-traumatic condylar hypoplasia, the facial asymmetry resolved; (2) in patient no. 2 suffering from unilateral facial hypoplasia, the asymmetry, which was severe, reduced with adolescence, but did not resolve; (3) in patient no. 3 suffering from fibro-osseous dysplasia of left maxilla, the asymmetry was reduced by surgery, but the full effects of the surgery were not measurable until over 1 year after operation; subsequently, the asymmetry began to increase again.- - - - - - - - - - ranking = 0.2keywords = mouth (Clic here for more details about this article) |
10/24. oral manifestations during chemotherapy for acute lymphoblastic leukemia: a case report.A 14-year-old, male patient was referred for the treatment of mucositis, idiopathic facial asymmetry, and candidiasis. The patient had been undergoing chemotherapy for 5 years for acute lymphoblastic leukemia. He presented with a swollen face, fever, and generalized symptomatology in the mouth with burning. On physical examination, general signs of poor health, paleness, malnutrition, and jaundice were observed. The extraoral clinical examination showed edema on the right side of the face and cutaneous erythema. On intraoral clinical examination, generalized ulcers with extensive necrosis on the hard palate mucosa were observed, extending to the posterior region. Both free and attached gingivae were ulcerated and edematous with exudation and spontaneous bleeding, mainly in the superior and inferior anterior teeth region. The tongue had no papillae and was coated, due to poor oral hygiene. The patient also presented with carious white lesions and enamel hypoplasia, mouth opening limitation, and foul odor. After exfoliative cytology of the affected areas, the diagnosis was mixed infection by candida albicans and bacteria. Recommended treatment was antibiotics and antifungal administration, periodontal prophylaxis, topical application of fluor 1.23%, and orientation on and control of proper oral hygiene and diet during the remission phase of the disease.- - - - - - - - - - ranking = 0.4keywords = mouth (Clic here for more details about this article) |
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