Tabla de contenidos
January March 2023
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.
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.
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.
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.
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.
Osteotomies to correct mandibular asymmetries. Series of casesLucas Cavalieri-Pereira -
Asymmetries are the most difficult dentofacial deformities to treat with orthognathic surgery. This occur due the anatomic alterations in mandibular form and contour, sometimes on body, ramus or condyle, or in all. In the most of cases, the first step is the uncoordinated condylar growth. So, some tools to solve this are the osteotomies to recontour the face. It’s known that mandibular growth with asymmetry can result in maxillary alterations, with plan tilted and unaesthetic smile. One of the most likely etiologies to these deformities are the hemimandibular hyperplasia resulting from condylar growth. The orthognathic surgery are a group of techniques performed to correct the maxilla, mandible and menton deformities. In some cases, hig condylectomy are done to prevent postoperative growth. To complement, the osteoplasties to recontour the mandible are done to improve aesthetic to the face. Series of cases are presented with different kinds of osteotomies in mandibular body, ramus and menton. Some cases need high condylectomy associated. The Virtual Surgical Planning (VSP) is an important step and tool to do cases with asymmetries.
KEY WORDS: Osteotomy, mandibular asymmetries.
CAVALIERI-PEREIRA L. Osteotomies to correct mandibular asymmetries. Series of cases. Craniofac Res. 2023; 2(1):37-50.
Efficacy of arthroscopy for the Management of internal disorders of the temporomandibular jointCarlos Gaete G. Paula Astorga J. Camila Foncea R. Bárbara Alvarado F. -
Internal derangement are the most common pathological conditions of the temporomandibular joint. The purpose of this study was to evaluate the success of arthroscopy in the treatment of internal disorders in a Chilean population, considering as parameters the increase in mouth opening and the decrease in pain perceived by the patient, in addition to determining if there were variables that influenced the results. A retrospective cohort study was carried out in which patients who received arthroscopy in one or both joints, performed by the same surgeon, were included. The sample included 67 patients operated on over a period of 2 years and 8 months, with a 1-month follow-up. The average increase in mouth opening at the month of control was 1.42 ± 8.4mm (p value = 0.172), with a relative percentage difference of 0.9 ± 0.3% and a statistically significant decrease in pain was observed in the VAS score. avera- ge (-2 ± 1.5 for the right side and -1.95 ± 1.7 for the left side; p value < 0.001). The pre-intervention pain level was the only variable that was associated with the degree of pain relief after surgery (OR=13.1 right side; OR=6.6 left side).
KEY WORDS: Temporomandibular joint, arthroscopy, internal derangement.
GAETE GC, ASTORGA JP, FONCEA RC ALVARADO FB. Efficacy of arthroscopy for the management of internal disorders of the temporomandibular joint. Craniofac Res. 2023; 2(1):51-57.
ecompression of central mandibular giant cell granuloma in a patient with polyostotic fibrous dysplasia. Case report and literature reviewPedro Tapia C. Javier Vargas A. Maria Ignacia Guerrero G. Pablo Arrue D. Sebastián Mordoh C. -
Central giant cell granuloma (CGCG) with polyostotic fibrous dysplasia (PFD) are rare lesions of the jaws and it is even less common for them to occur simultaneously, giving rise to hybrid lesions. When this type of mixed lesions are extensive, therapeutic alternatives are limited and extensive bone resections must often be performed. The aim of this case report is to document the remission of an extensive hybrid lesion (PFD + GCCG) of the mandible unexpectedly after the use of decompression therapy prior to knowing the result of the histopathological study; providing a successful result that can avoid resective surgeries in this specific type of infrequent mixed lesions.
KEY WORDS: Fibrous dysplasia, central giant cell granuloma, hybrid lesions, mixed injuries.
TAPIA CP, VARGAS AJ, GUERRERO GMI, ARRUE DP, MORDOH CS. Decompression of central mandibular giant cell granuloma in a patient with polyostotic fibrous dysplasia. Case report and literature review. Craniofac Res. 2023; 2(1):58-64.
Emerging treatment of medication-related osteonecrosis of the jaw: A narrative reviewSergio Gutiérrez Braghetto Javiera Cancino González Pablo Navarro Wike Claudia Mancilla Villalobos -
Medication-related osteonecrosis of the jaw is an adverse effect of antiresorptive drugs, characterized by the presence of necrotic bone in the maxillofacial area, with or without bone exposure, which does not heal in 8 weeks in patients without oral cancer and without having received radiotherapy in the craniofacial region. There are different factors that increase the risk of developing this pathology, and its diagnosis is based on categorizing the lesion into four stages according to its progression. Although there is no standard treatment reported in the literature for medication-related osteonecrosis of the jaws, AAOMS in its latest update in 2022, describe that the main therapeutic objective is to eliminate the pain, control the infection and prevent the progression and occurrence of bone necrosis, maintain or improve the quality of life . This had led to researchers an physicians to seek new adjuvant therapeutic alternatives to conservative and surgical treatment, which can be found reported on the literature the use of hyperbaric oxygen, laser therapy, platelet concentrates, ozone and anabolic agents such as teriparatide and recombinant human bone morphogenetic protein, antioxidants as vitamin E and pentoxifylline in order to improve the prognosis and quality of life of the patients. In the present review results manually extracted from the articles indexed in the PUBMED and SCOPUS databases that respond to de search for the terms: medication-related osteonecrosis of the jaw, treatment and oral surgery, were used, with the aim of describing the emerging treatments for medication-related osteonecrosis of the jaws, discussing the different therapeutic approaches described.
KEY WORDS: Medication-related osteonecrosis of the jaw, treatment and oral surgery.
GUTIÉRREZ BS, CANCINO GJ, NAVARRO WP, MAN- CILLA CV. Emerging treatment of medication-related osteonecrosis of the jaw: A narrative review. Craniofac Res. 2023; 2(1):65-71.
Epidemiology of maxillofacial fractures with surgical resolution treated at the Dr. Teodoro Gebauer Weisser Traumatology Institute (Chile): 2011-2020 ReviewRodrigo Medina Astrid Häberle Mónica de La Fuente Edgardo Pineda Gustavo Gazitua Patricio Cerda Cristian Núñez Nicolas Palma -
Maxillofacial trauma has an important incidence worldwide, associated with high morbidity, loss of function, aesthetic sequelae, and significant monetary cost for public health institutions, since most of them require hospitalization. In addition, they generate the need for highly qualified personnel, and timely diagnosis is of vital importance. The prevalence and incidence of maxillofacial fractures have been widely described, however, the results usually present differences due to the sociocultural, demographic and development level of each country. Our objective is to describe the frequency of maxillofacial fractures treated surgically by the oral and maxillofacial surgery team of the Instituto Traumatológico Dr. Teodoro Gebauer Weisser between the years 2011-2020. A review of the clinical records was carried out identifying the following variables: anatomical site of the fractures, affected side, etiology, date of intervention, patient age and sex. The sample consisted of 596 patients with 969 maxillofacial fractures. On average, the patients had 1.6 fractures. The 80.4% corresponded to men. The average age was 40.2 years, with the 30-39 years category being the most affected.Of the total number of fractures operated on, 50.3% occurred on the right side, 52% on the mandible. The most frequent anatomical site of fracturewas the mandibular angle, followed by parasymphisiary fractures and fractures of the orbito-maxillo-malar complex. The main cause was aggression by third parties (49%), followed by traffic accidents and falls. Within the 10 years included, 2011 was the year with the highest number of patients operated on (81), in contrast to 2020, when only 35 were operated on. The results obtained allow us to describe the distribution of maxillofacial fractures requiring surgical treatment in the population studied. The data obtained show similar characteristics to other studies in relation to the affected population and the location or anatomical site of the fractures.
KEY WORDS: Maxillofacial trauma; Mandibular fractures, Maxillary fractures, Epidemiology.
MEDINA R, HÄBERLE A, DE LA FUENTE M, PINEDA E, GAZIUA G, CERDA P, NUÑEZ C, PALMA N. Epidemiology of maxillofacial fractures with surgical resolution treated at the Dr. Teodoro Gebauer Weisser Traumatology Institute (Chile): 2011-2020 Review. Craniofac Res. 2023; 2(1):72-78.