Condylar hyperplasia multidisciplinary treatment: report of 4 cases

Abstracts teroids and absence of any degenerative factors. Although related literature emphasize systemic corticosteroids could cause changes on the condylar component (thickness, connection and dispersion of collagen fibrils) of the joints; we can tell that while presence of predisposing factors exist, systemic corticosteroids may induce the chronic changes on the joints depending on dosage and periods. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.650

388 Condylar hyperplasia multidisciplinary treatment: report of 4 cases ˜ 1, H. Ramirez Skinner 1,∗ , I. Goni C. Reinoso 2 , R. Schulz 2 , F. Hormazabal 3 , A. Vargas 1 , D. Fontbote 4 , D. Lazo 5 1 Surgical Oncology and Maxillofacial Surgery, Santiago, Chile 2 Orthodontics Unit, San Joaquin Medical Center, Santiago, Chile 3 Orofacial Pain Unit, San Joaquin Medical Center, Santiago, Chile 4 Implantology and Oral Surgery, San Joaquin Medical Center, Pontificia Universidad Catolica de Chile, Santiago, Chile 5 Universidad Mayor, Santiago, Chile

Condylar hyperplasia is considered a rare pathology which is characterized by progressive facial asymmetry, defined as a non-neoplastic growth which affects both size and morphology of the mandibular condyle. With unknown etiology, its diagnosis is based on a meticulous clinical examination back up with accurate images ranging from traditional X-rays to bone scintigraphy, PET-SCAN and SPECT. The treatment of this pathology is the elimination of the condylar growth center and secondary correction of the structural deformities with procedures selected by severity, age and previous systemic condition. In this four cases report we discuss the management of patients with different clinical features who were treated in a multidisciplinary approach which includes, orthopedic treatment of the TMJ, orthodontics and surgery in 1 or 2 surgical events. Every patient had a clinical diagnosis plus an SPECT exam which supported the clinical findings. Patients were treated by an orthodontist and a TMJ specialist before the surgical treatment. Surgery included high condylectomy and articular disc repositioning as the primary objective in all the subjects and orthognathic surgery

in the same surgical time when necessary. All of the patients showed no signs of recurrence, improvement in their mandibular dynamics, occlusal stability and no signs or symptoms of dysfunctional TMJ. Conflict of interest: Main author is member of ICOMS Scientific Commission.

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capacity was 38.5 mm for patient with ankylosis. Joint related pain and interference with eating were eliminated. There was no postoperative complication. Conclusion: Total TMJ reconstruction seems to be a reliability procedure and must be taken in consideration in patient with severe damage of TMJ. Conflict of interest: None declared.

doi:10.1016/j.ijom.2011.07.651 doi:10.1016/j.ijom.2011.07.652

389 Temporomandibular joint total replacement using Biomet® prostheses: a prospective study

390 Neonatal TMJ ankylosis as a complication of septic arthritis infection

X.-A. Mommers 1,∗ , O. Trost 2 , N. Zwetyenga 2 1 Department of Oral and Maxillofacial Surgery, Plastic and Reconstructive Surgery, Hand Surgery, University Hospital, Dijon, France 2 Oral and Maxillofacial Surgery, Plastic and Reconstructive Surgery, Hand Surgery, University of Bourgogne, Medicine Faculty, Dijon, France

A. Bakathir 1,∗ , A. Al-Hashmi 2 Oral Health Department, Sultan Qaboos University Hospital, Muscat, Oman 2 Dental, Oral and Maxillofacial Surgery, Al-Nahda Hospital, Ministry of Health, Muscat, Oman

Introduction: Many of temporomandibular joint disorders patients are managed with non-surgical therapies, but some patients require surgical TMJ repair or reconstruction. Reconstruction is indicated when the joint is severely damaged. Total TMJ reconstruction is performed using several models of alloplastic implants. The aim of this study was to present our experience of total TMJ reconstruction using Biomet® prosthesis. Material and methods: All diagnoses were established with clinical and MRI and 3D-CT-scan data. Preoperative stereolithographic models were built in all cases. We used Biomet microfixation (Jacksonville, FL, USA) devices. The Biomet® total TMJ prosthesis can be used as a stock product or an individually designed prosthesis. In case of stock product there are fixed sizes and shapes. The surgical approach was through one preauricular incision, and one retromandibular incision. The patients did not require any postoperative IMF. They were allowed to function immediately, with freedom to choose any diet. Jaw-opening exercises were instituted immediately after surgery. Patients were regularly followedup. Results: There are 3 women and 2 men. Nine total TMJ prostheses have been inserted between 2009 and 2011. Four patients had unilateral procedures and one had a bilateral procedure. The follow-up ranged between 12 and 24 months. At the end of the study the mean jaw-opening

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TMJ ankylosis as a complication of infection is a known but extremely rare presentation, with scientific literature reporting very few published cases. Septic arthritis infections occurring in a neonate with involvement of the TMJ region could lead to ankylosis as a result of this unusual infection process, which are often caused by Staph. aureus bacteria. Neonatal TMJ ankylosis can cause severe functional disability and also interfere with the harmony of facial growth. This poster presentation describes a clinical case of unilateral TMJ ankylosis in a 15-months old male baby occurring as a complication of neonatal septic arthritis infection. The clinical presentation showed severe limited mouth opening of 11 mm and deviation of the jaw to the ankylosis side. Radiographic examination using CT scan showed unilateral gross enlargement of the right TMJ with ankylosis to the base of the skull. This neonate at age of 16 months, the youngest child according to published reports, was treated surgically by gap arthroplasty and interpositional temporalis fascia graft with an immediate increase of mouth opening to 20 mm. The patient was followed by immediate active jaw physiotherapy with initial successful outcome. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.653