• Title/Summary/Keyword: mandibular condyle

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Condyle dislocation following mandibular reconstruction using a fibula free flap: complication cases

  • Kang, Sang-Hoon;Lee, Sanghoon;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.14.1-14.10
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    • 2019
  • Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

The impact of the presence and aspect of mandibular third molars to the mandibular angle and condyle fractures (하악 제3대구치의 존재여부 및 매복양상이 하악 우각부 골절과 과두 골절의 발생에 미치는 영향)

  • Lee, Young-Joo;Song, Yun-Jung;Hong, Soon-Min;Chae, Sang-Sik;Kang, Hyeon-Woo;Choi, Dong-Ju;Park, Jun-Woo
    • The Journal of the Korean dental association
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    • v.50 no.9
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    • pp.566-573
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    • 2012
  • Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.

Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

  • Kim, Dong Sung;Kim, Jae-Young;Jeong, Chan-Woo;Park, Kwang-Ho;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.5
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    • pp.259-264
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    • 2015
  • We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.

CONSERVATIVE RESECTION OF OSTEOCHONDROMA ON MANDIBULAR CONDYLE : A CASE REPORT (하악 과두에 발생한 골연골종의 보존적 제거 1 예)

  • Nam, Jung-Woo;Kim, Jae-Young;Kim, Hak-Jin;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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    • pp.257-260
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    • 2009
  • Osteochondroma is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones and extremely rare in mandibular condyle. The clinical signs and symptoms of osteochondroma of mandibular condyle may resemble those seen in patients with temporomandibular joint (TMJ) dysfunction. Condylectomy have been the first choice for treatment of osteochondroma, but it may be with some complicaitons, loss of condylar vertical height, etc. A 57 years old female patient who had an osteochondroma on left mandibular condyle visited to our clinic. We did surgically remove the mass with favorable result, so we present the case with review of literatures.

AN EXPERIMENTAL STUDY ON THE CHANGE OF CONDYLE HEAD AFTER MANDIBULAR RAMUS OBLIQUE OSTEOTOMY (하악지 사선골절단술 후 하악두의 변화에 관한 실험적 연구)

  • Cha, Seon-Kyung;Kim, Yeo-Gab
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.65-76
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    • 1992
  • This study was designed to observe the adaptive changes of mandibular condyles to displacement of mandibular condyle in adult animals. In this study, 16 rabbits weighting about 3.5 kg was selected. Four rabbits were preserved for control group and 8 animals were divided into 3 groups, 2 weeks, 4 weeks and 8 weeks. The experimental animals were performed oblique osteotomy on both mandibular ramus and internal wiring at mandibular border. The experimental animals were sacrificed consecutively on the 2 weeks, 4 weeks and 8 weeks after oblique osteotomy and mandibular condyles were dissected out carefully to produced tissue specimen. The specimens were fixed with 10% N formaline solution for 24 hours and rinsed with phosphate buffer solution. It was decalcified with 5% nitric acid for 15 days. Thereafter the specimens were dehydrated in alcohol series and embedded paraffin as usual manner. The mebedded specimen were sectioned in $4-6{\mu}m$ microtome, stained with hematoxylin-eosin and azan stain and observed through light microscope. The following results were observed from this experiment. When there was postional change of condyle head after mandibular ramus oblique osteotomy in adult rabbit, 1. The density of chondrocyte was generally increased at condylar cartilage and the thickness of condylar cartilage was increased posterosuperior aspect of the mandibular condyle slightly. 2. The density of chondrocyte was increased at proliferative zone so fibrous articular zone, porliferative zone and hypertrophic zone was clearly distinguished. 3. Active endochondral bone formation was occurred at mandibular condyle.

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LONG-TERM EVALUATION OF MANDIBULAR CONDYLE FRACTURES (하악 과두 골절에 관한 장기추적조사연구)

  • Min, Seung-Ki;Park, Sang-Kyu;Oh, Seung-Hwan;Kwon, Kyung-Hwan;Choi, Mun-Ki;Chae, Young-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.535-544
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    • 2005
  • The management of mandibular condyle fractures continues to be a subject of much debate. It is suggested that, if not properly managed, these fractures may give rise to serious problems, such as malocclusion, mouth opening limitation, temporomandibular joint disorders. Treatment planing of mandibular condyle fractures is very important. The aim of this present study was to evaluate the long-term results according to treatment methods in condylar fractures. Also, it was to evaluate results of treatment according to condylar fracture level. We conducted a retrospective analysis of 43 mandibular condyle fractures. 43 patients followed for average period of 9.00 years(mini. 7yr, max. 12yr). All patients underwent a clinical and radiologic evaluation focusing on mouth opening, mandibular movements, TMJ function, change of ramal height, condylar remodelling. If the level of fracture was positioned in high, especially in level II, mandibular movement disability and ramus length loss was more prominent. This results were similar to the cases of treatment of fragment removal. In high level fracture and fragment removal cases, It is thought that more intensive and long term management are needed than other treatment cases using different operation methods. Also, direct fixation by each approach showed good results in mandibular movement, ramal height change and condylar shape. Through this results, accurate reduction of the mandibular condyle fractures was a very important factor in postoperative prognosis.

The Osteochondroma of the Mandibular Condyle: Report of a Case (하악과두에 발생된 골연골종의 증례보고)

  • Choi Wook-Jin;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.30 no.2
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    • pp.138-143
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    • 2000
  • The osteochondroma, also known as osteocartilagenous exostosis, is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction. Sometimes, differentiation between osteochondroma and condylar hyperplasia is not possible on histologic grounds alone, but the radiographic and intraoperative findings together are usually sufficient to establish a definite diagnosis. This report reviews the literature concerning osteochondroma, especially of the maxillofacial region, and describes a case of osteochondroma of the condyle.

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Post-traumatic bifid mandibular condyle: A case report and literature review

  • Woo, Min-Ho;Yoon, Kyu-Ho;Park, Kwan-Soo;Park, Jae-An
    • Imaging Science in Dentistry
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    • v.46 no.3
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    • pp.217-222
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    • 2016
  • Bifid mandibular condyle (BMC) is an uncommon morphological variant of the mandibular condyle. Although authors have proposed various etiologies for BMC, no consensus has emerged. In addition, varying findings have been reported regarding the epidemiological parameters of BMC (e.g., prevalence, gender ratio, and age), possibly due to its low incidence. BMC is occasionally associated with symptoms of the temporomandibular joint, such as ankylosis, pain, and trismus; however, it is difficult to detect this condition on conventional radiographs. This study reports a case of BMC with radiographic findings, and reviews the literature on the epidemiology of BMC.

A CLINICO-RADIOLOGIC STUDY OF BONY REMODELING OF THE FRACTURED CONDYLES IN CHILDREN (소아에서 골절된 하악과두의 골개조 양상에 관한 임상 및 방사선학적 연구)

  • Cho Jeong-Shin;Park Chang-Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.471-482
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    • 1995
  • Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age. They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group(83%). 2. Fallen down(54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to paipation09 cases). Mouth opening limitation07 cases), swelling(7 cases), malocclusion(3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients(44%). Condyle fractures with symphysis fracture(9 patients, 39%), condyle fractures with ascending ramus fracture(2 patients, 9%), condyle fracture with mandibular body fracture(1 patient, 4%), and condyle fractures with mandibular angle fracture(1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, dispiacement(17 cases, 66%) was most common. Dislocation(5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual condylar shape in 23 cases and with prominently different shape in 3 cases.

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A CASE REPORT OF REMOVAL OF FOREIGN BODY AND REDUCTION OF CONDYLE FRACTURE, SEQUELAE OF GUN SHOT WOUND. (안면부 총상으로 인한 하악과두 골절 환자의 치험 예)

  • Kim, Hyoun-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.55-59
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    • 1995
  • Today, with the development of modern civilization, the change of industrial structure and the increase of traffic volume and population make the number of maxillofacial injury patients also increase. Especially, the fracture possibilities of mandibular condyle have been increased because of mandibular position and shape. I experienced the case that mandibular condyle fracture caused by gun-shot injury(Bullet had been packed at the opposite condyle of input site) was treated by foreign body removal and condyle open reduction. I will represent that case with the journal review.

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