Osteochondroma of TMJ (Case Report)

Treatment:

• Under GA condylectomy with modified temporal incision was performed.On exposing the condyle, it was observed that the tumor could not be separated from the condyle.Curettage and suturing.

Final diagnosis:

Histopathology:

Differential

Diagnosis

Radiographic

Examination

• achievement of acceptable mouth opening ranges.
• recover her facial symmetry
• reestablish facial harmony and occlusion

Based on clinical examination,

patient history

complementary tests,

a diagnosis of osteochondroma hypothesized.

The histopathological examination has confirmed the diagnosis.

• osteoma
• chondroma
• giant cell tumor
• myxoma
• fibro-osteoma
• fibrous dysplasia
• fibrosarcoma
• chondrosarcoma

• Age:2o y
• Sex: female
• Chief complaint:

*eating difficulty

*facial asymmetry

*pain in the left TMJ

*slowly progressive facial

asymmetry & tooth crowding for

at least 4 years

• No history of trauma

• Severe malocclusion
• facial asymmetry with approximately10 mm deviation of the midline to the left side
• Posterior crossbite on the right side
• negative overjet resulting in eating difficulty
• maximum mouth opening 34mm
• Class I occlusion without open bite

Panoramic radiograph showing a radiopaque mass on the left condylar region.

All have the same clinical picture

Scintigraphy with 99mTc-HMDP show an intense uptake of radiopharmaceutical in the left condyle (arrows).

Made By:

Hala Ahmed Morsy

Heba Ali Hassan

• Most cases reported in the literature did not associate surgery with orthodontic treatment

A = Sequences of coronal CT images in bonewindow showing irregular mass of mineralization in the condyle.B = Sequences of axial CT images in bone window showing alarge nodular mass around the left TMJ.

• Camouflage treatment could be done to correct dental asymmetries

.When facial asymmetry persists after surgery, orthognathicsurgery is recommend for correction.

• BUT in the present case,

orthodontic treatment :

• corrected the tooth crowding
• did not correct the facial asymmetry.
• Therefore Orthodontic treatment was performed along with surgical treatment for correction of tooth crowding & to minimize facial asymmetry.

SURGERY

• Mandibular movements could be easily performed without pain.
• Complete correction of the malocclusion and midline deviation could not be achieved

guiding elastics for 2 weeks to guide the correct mandiular position

Jaw exercises for 3 weeks and repeated 5 times a day after removal of the elastics.

After

Before

after 3 years of postoperative follow up and orthodontic therapy, neither recurrence nor complications were observed.

. The patient was satisfied with the postoperative results and remission of pain.

Postoperative views. Front (A) and lateral (B) views ofthe facial appearance 3 years after surgery; C and D= Bilateral views of occlusion.

The orthodontics treatment was continuedafter surgery.