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Pleomorphic adenoma in palate – Case reportsAlan Polanco Fernanda Villalobos Rodrigo Allende Liberto Figueroa -
Pleomorphic adenoma is the most frequent benign neoplasm of the salivary glands and usually manifests as painless masses of firm consistency and slow growth, located in relation to the parotid gland and minor salivary glands located in the palate. The diagnosis is established by histopathological analysis and its treatment consists of surgical excision with safety margins due to possible recurrence or malignant transformation of the entity. In the present study we propose to update the knowledge about this pathology by reporting 3 cases of pleomorphic adenoma of palatal location with similar clinical, histologic and radiographic features, which were treated by surgical excision with safety margins and installation of palatal containment.
KEY WORDS: Pleomorphic adenoma, mixed salivary tumor, adenoma, case report, palate, benign tumor.
POLANCO A, VILLALOBOS F, ALLENDE R, FIGUEROA L. Pleomorphic Adenoma in palate – Case reports. Craniofac Res. 2023; 2(1):1-7.
Stepped genioplasty using cutting and positioning guide: A case reportGermán Laissle Diego Fonseca Fernando Parada Antonio Núñez María Loreto Castellón Carlos Fuenzalida Carlos Bahamondes -
Genioplasty is a procedure used to modify the natural anatomy of the chin, based on an osteotomy of the lower edge of the jaw that allows three-dimensional repositioning of the chin. Currently, various techniques are described to perform genioplasty, being the staggered technique, a modified technique used for elusive chins with vertical excess of the lower third. A genioplasty, virtually previously planned, was performed with a stepped technique using a cutting and positioning guide in an 18- year-old patient with a history of class II dentofacial dysmorphosis that affected both functionally and aesthetically the lower third. Genioplasty with the stepped technique allows addressing the vertical excess of the chin, both at the level of the symphysis, allowing to manage the projection of the chin and deepening of the labiomental fold, achieving smooth transitions between the symphysis and the ramus of the mandible in comparison with other techniques. conventional. The use of cutting and positioning guidance allowed to obtain previously planned intraoperative osteotomies, obtaining virtually predictable and complication-free planned aesthetic results.
KEY WORDS: Genioplasty; Step-technique; Orthognathic surgery; Virtual planning
LAISSLE G, FONSECA D, PARADA F, NÚÑEZ A, CASTELLÓN ML, FUENZALIDA C, BAHAMONDES C. Stepped genioplasty using cutting and positioning guide: A case report. Craniofac Res. 2023; 2(2):79-82.
Extraoral exposure of mandibular reconstruction plateRodrigo Medina Sanchez Edgardo Pineda Taladriz Hilda Moris Vidal Mónica de la Fuente Escalona Marcelo Mardones Muñoz -
Maxillofacial reconstruction systems have presented an incredible advance in terms of implementation techniques and properties. These systems have been adapted throughout history, through medical and orthopedic principles, exceeding minimum requirements in relation to their resistance (to provide functional stability), ductility, and above all, biocompatibility. In this way, experimental studies in both biomechanics and pathophysiology of osseointegration have given these system high reliability and prognostic accuracy. However, there are limitations and requirements to be considered, in order to avoid complications such as fracture of the material, loss of stability of the rigid fixation, infection, both intra and extra oral exposure of the reconstruction plate, among others. The purpose of this article is to report a case of extra oral exposure of a mandibular reconstruction osteosynthesis plate in a patient undergoing hemimadibulectomy after severe mandibular osteomyelitis, presenting the diagnosis, management and treatment performed by the team of specialists.
KEY WORDS: Mandibular osteomyelitis, infection, mandibular reconstruction plate.
MEDINA SR, PINEDA TE, MORIS VH, DE LA FUEN- TE EM, MARDONES MM. Extraoral exposure of mandibular reconstruction plate. Craniofac Res. 2023; 2(1):8-14.
Osteochondroma of mandibular condyle: Review of treatment alternatives for purpose of a clinical caseCarlos Gaete Paula Astorga Cristóbal Araya Bárbara Alvarado Felipe Pineda -
Osteochondroma is the most common benign bone tumor, representing 10 to 15% of all bone tumors. We present the case of a 44-year-old patient who presented with progressive deviation to the right of 6 months evolution. On examination, he presented facial asymmetry with a right crossbite. The imaging study revealed an exophytic mass of 16x7x10mm located cranially and laterally in relation to the head of the left mandibular condyle, being compatible with an osteochondroma. Complete excision of the lesion was realized using a preauricular approach, accompanied by an arthroplasty with discopexy with an anchor. After the surgical intervention, the patient performed physiotherapy and continued with orthodontic treatment. Condyle osteochondroma is an unusual pathology, until 2010 there were ninety-eight cases described and there are no established treatment algorithms. The objective of this work is to present a case of osteochondroma of the mandibular condyle treated by arthroplasty with preservation of the articular disc.
KEY WORDS: TMJ, arthroplasty, osteochondroma, mandibular condyle.
GAETE C, ASTORGA P, ARAYA C, ALVARADO B. Osteochondroma of mandibular condyle: review of treatment alternatives for purpose of a clinical case. Craniofac Res. 2023; 2(2):83-88.
Eagle syndrome: a comprehensive review of an underestimated conditionMarco Xavier Vizuete Bolaños Mario Alberto Teliz Meneses Oskar Eduardo Prada Vidarte Philippe Jerez Robalino Oscar Rohel Hernández Ortega Edgar Patricio Olmedo Bastidas Abigail Miranda Gallegos -
The eagle syndrome (ES) is a commonly misdiagnosed condition caused primarily by it has a variety of signs and symptoms. Recent studies relate (ES) to some types of craniofacial pain that can be confused with other diseases and cause cerebrovascular accidents due to carotid artery dissection if this condition is considered a dynamic/positional pathology. It ́s important to have a multidisciplinary approach to the (ES) that allow us to understand it ́s pathophysiology, main clinical patterns, diagnostic methods, and treatments. The aim of this manuscript is to carry out an exhaustive review of the pathophysiology, clinical patterns, available diagnostic tools, treatments, and the presentation of a clinical case to guide clinicians through this underestimated condition.
KEY WORDS: Styloid process, neck pain, calcification, neck angulation.
VIZUETE BMX, TELIZ MMA, PRADA VOE, JEREZ RJP, HERNÁNEZ OOR, OLMEDO BEP, MIRANDA GRA. Eagle syndrome: a comprehensive review of an underestimated condition. Craniofac Res. 2023; 2(1):15-21.
Structured summary of evidence using Epistemonikos (FRISBEE): experience of a new type of evidence synthesis in maxillofacial surgeryMatías Dallaserra Albertini Juan Pablo Vargas Buratovic Salvador Valladares Pérez Duniel Ortuño Borroto María Francisca Verdugo Paiva Julio Villanueva Maffei -
Oromaxillofacial surgery, dedicated to the diagnosis and treatment of pathologies in the stomatognathic region, faces challenges in clinical decision making due to the lack of randomized clinical trials and methodological limitations in primary studies. Evidence- based medicine, although useful, presents difficulties in this field. To address these limitations, the FRISBEE (FRIendly Summary of the Body Evidence using Epistemonikos) methodology, a structured summary of systematic reviews, is introduced. A FRISBEE seeks to synthesize all relevant biomedical information related to a specific clinical question, using systematic reviews. A detailed process is followed, from the formulation of the clinical question to the synthesis of data using the GRADE methodology, which evaluates the certainty of the evidence. The consulted literature shows 13 FRISBEEs in oromaxillofacial surgery, revealing precise results, such as the use of antibiotic prophylaxis to prevent the loss of bone-integrated implants and post-operative infection in orthognathic surgery. In conclusion, oromaxillofacial surgery faces challenges in the quality and certainty of the available information. FRISBEEs offer a synthesis of evidence that is accessible and easy to interpret, improving decision making in this specialty. Its application has proven to be valuable by providing clear and precise conclusions about various interventions in oromaxillofacial surgery, highlighting its usefulness in clinical practice.
KEY WORDS: Oromaxillofacial surgery, FRISBEE, clinical evidence, GRADE methodology.
DALLASERRA AM, VARGAS BJP, VALLADARES PS, ORTUÑO BD, VERDUGO PMF, VILLANUEVA MJ. Structured summary of evidence using Epistemonikos (FRISBEE): experience of a new type of evidence synthesis in maxillofacial surgery. Craniofac Res. 2023; 2(2):89-95.
Synchronus central cemento-ossifying fibroma and supernumerary tooth in the maxilla. Case report and review of the literatureNicolás Felipe Ríos Esposito Isidora Valesca Neira Cisternas Macarena Pía Toro Mardones Luis Alfonso Romo Sanhueza -
Cemento ossifying fibroma (COF) is a benign fibro-osseous lesion, which occurs mainly in women, between the 3rd and 4th decade, affecting the posterior mandibular region. In this article, an atypical presentation of COF is presented synchronously with a supernumerary tooth included in the maxilla, and a review of the literature is carried out. A 17-year-old male patient, with a radiographic finding of a supernumerary tooth included and an asymptomatic increase in vestibular volume in the maxilla, which causes den- tal malposition. Extraction of the supernumerary tooth and excisional biopsy of the vestibular lesion were performed under local anesthesia. The histopathological study reports a fibro cellular tissue with calcifications similar to bone trabeculae, compatible with Central Ossifying Cement Fibroma. The etiology of COF is uncertain and its mechanism is still unknown, but it could have a genetic or traumatic component as a triggering factor. The literature shows limited reports presented in the maxilla, its characteristics are summarized in this article. A presentation of OFC simultaneously with supernumerary teeth has not been reported, however, it has been presented in conjunction with other injuries or multiple COF.
KEY WORDS: Fibroma, ossifying; maxilla; tooth supernumerary.
RÍOS ENF, NEIRA CIV, TORO MMP, ROMO SLA. Synchronus central ce- mento-ossifying fibroma and supernumerary tooth in the maxilla. Case report and review of the literature. Craniofac Res. 2023; 2(1):22-26.
Melkersson Rosenthal Syndrome: An unusual diagnosis and presentationPablo Navarro Wike Sergio Gutiérrez Braghetto Salazar Claudia Mancilla Villalobos -
The Melkersson-Rosenthal syndrome is characterized as a rare neuro-muco-cutaneous clinical syndrome, whose distinctive features include the simultaneous presentation of a triad of clinical signs: recurrent facial paralysis, orofacial edema, and fissured tongue. This combined manifestation is observed in only 8% to 25% of documented cases. The case of a patient diagnosed with Melkersson-Rosenthal syndrome with a two-year history is presented. The presence of the classical triad is noteworthy, and such a comprehensive presentation is infrequently reported in the existing literature. Clinical and histopathological findings associated with the case are discussed.
KEY WORDS: Fissured tongue, facial palsy, orofacial swelling, Melkersson-Rosenthal Syndrome.
NAVARRO WP, GUTIÉRREZ BS, MATURANA AA, ARAVENA SJP, MANCILLA VC. Melkersson Rosenthal Syndrome: An unusual diagnosis and presentation. Craniofac Res. 2023; 2(2):96-99.
Retrospective study of predictability in virtual surgical planning in linear and angular maxillary movements after orthognathic surgery in malocclusion Class II and III patients. A retrospective study – Part ILucas Cavalieri-Pereira Christian José de Oliveira Macedo Ana Júlia Coral1 Gabriela Pedroso de Oliveira -
A retrospective study was developed to find the Virtual Surgical Planning (VSP) predictability in maxillary movements after orthognathic surgery. Linear and angular measurements were done in malocclusion class II and III patients through face and skull Computed Tomography (CT) with dental scan (called Compound Skull), using surgical planning, comparing with postoperative CT with at least 6 months. Eight patients participated of the study. The results to the simulated and real movements of maxillary points were compared, calculating their linear and angular differences. The cephalometric analysis were done using the Proplan software (Materialise Proplan CMF, São Paulo, Brazil). Eight measurements were done and evaluated through of the t test, Bland-Altman, Wilcoxon and the Dahlberg error, in addition to being evaluated by clinically acceptable bias (+/- 2mm). In the total, 3 differences were statistically significant (anterior facial height, HFP/ULM, HFP/UI). The VSP seems to be a precise and reproducible method as a way of elaborating treatments, reliably transferred to the patient through surgical guides. Although the three differences were statistically significant, when clinical measurements compared with them, none gave clinically significant.
KEY WORDS: Orthognathic surgery, malocclusion, facial asymmetry.
CAVALIERI-PEREIRA L, MACEDO OCJ, CORAL AJ, OLIVEIRA GP. Retrospective study of predictability in virtual surgical planning in linear and an- gular maxillary movements after orthognathic surgery in malocclusion Class II and III patients. A retrospective study – Part I. Craniofac Res. 2023; 2(1):27-36.
Influence of unilateral posterior crossbite in the development of the stomatognathic system: a literature reviewPaola Berdeja Felipe Soto Valentina Morales María Fernanda Atria -
The literature suggests posterior crossbite as a risk factor for the development of maxillomandibular developmental disorders. However, the results of these studies are heterogeneous and outdated, which prevents asserting the influence of this malocclusion on the craniofacial system. The aim was to collect available information regarding the influence of posterior crossbite on the skeletal, articular and neuromuscular systems to establish general conclusions about its association and lay the foundations for the generation of new studies that allow the development of protocols and evidence-based decisions. A search of the literature was carried out in Pubmed, Scopus, Cochrane and Epistemonikos databases, with the strategy: crossbite AND temporomandibular OR asymmetry NOT orthognathic, contemplating studies from 2013 to 2023. A total of 2,852 articles were collected, of which 14 studies met the established inclusion criteria. The posterior crossbite would have a positive relationship for the development of asymmetries in both musculature and bone structures such as the jaw and structures relevant to the temporomandibular joint. More studies are needed that use complementary tests as a method of diagnosis/ analysis that reduce the overlapping of structures and distortion, thus reducing the possibility of error, in this way it is possible to standardize the results obtained and establish reliable conclusions to be used in clinical practice.
KEY WORDS: Malocclusion, posterior crossbite, facial asymmetry, temporomandibular disorders.
BERDEJA P, SOTO F, MORALES V, ATRIA MF.Influence of unilateral posterior crossbite in the development of the stomatognathic system: A literature review. Craniofac Res. 2023; 2(2):100-104.