Bilateral Temporomandibular Joint Ankylosis with Rare Finding of Odontogenic Keratocyst Extending into Ankylosed Segment: An Anomaly within Anomaly


Affiliations

  • Government College of Dentistry, Indore, Department of Oral and Maxillofacial Surgery, Madhya Pradesh, 452001, India

Abstract

Temporomandibular joint ankylosis is a pathological condition where the mandible fused to the glenoid fossa by bony and fibrotic tissues, which leads to a restriction of the mouth opening from partial reduction to complete immobility of the jaw. It is most commonly associated with trauma followed by local or systemic infection, tumors or systemic disease such as ankylosing spondylitis, rheumatoid arthritis, or psoriasis. This is a case report of an unusual presentation of bilateral Temporomandibular Joint (TMJ) ankylosis with rare finding of odontogenic keratocyst extending into the ankylosed segment. The CT scan revealed a welldefined with multicystic radiolucency appearance replaced the usual picture of TMJ ankylosis of a radio-opaque mass obliterating the normal architecture of the joint. Surgical exploration revealed cystic cavity filled with cheesy material within the ankylosed mass on right side of TMJ.


Keywords

Temporomandibular Joint, Odontogenic Keratocyst, Keratocystic Odontogenic Tumor

Subject Discipline

Dentistry

Full Text:

References

Okeson J O. Differential diagnosis and management considerations of temporomandibular disorders. In: Okeson JP(ed). American Academy of Orofacial Pain. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Chicago: Quintessence, 1996:113– 158.

Bavitz JB, Chewning LC. Malignant disease as temporomandibular joint dysfunction: Review of the literature and report of case. J Am Dent Assoc 1990; 120:163–166. https://doi.org/10.14219/jada.archive.1990.0041

Warner BF, Luna MA, Robert Newland T. Temporomandibular joint neoplasms and pseudotumors. Adv Anat Pathol 2000; 7:365–381. https://doi.org/10.1097/00125480-200007060-000 04

Gadre KS, Zubairy RA. Aneurysmal bone cyst of the mandibular condyle: Report of a case. J Oral Maxillofac Surg 2000; 58:439–443. https://doi.org/10.1016/S02782391(00)90932-7

Isidoro Cortell-Ballester 1 Rui Figueiredo, Leonardo BeriniAytés, Cosme. Traumatic bone cyst: A retrospective study of 21 cases. Med Oral Patol Oral Cir Bucal. 1 May 2009; 14 (5): E239-43.

Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans’ cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol. February 2005; 35(2):103–15. Epub 2004 July 28. https://doi.org/10.1007/s00247-004-1262-0

Bayazit Y, Sirikci A, Bayaram M, Kanlikama M, Demir A, Bakir K. Eosinophilic granuloma of the temporal bone. Auris Nasus Larynx. Jan 2001; 28(1): 99–102. https://doi.org/10.1016/S0385-8146(00)00078-X

IE EL Hakim, S.A Metwalli. Imaging of temporomandibular joint ankylosis, a new radiographic classification. J Dentomaxillofac Rad (2002):31, 19–23. https://doi.org/10.1038/sj.dmfr.4600660

Iram A, Muhammad J. Temporomandibular joint ankylosis: Experience with interpositional gap arthroplasty at Ayub Medical College. Abbottabad. J Ayub Med Coll Abbottabad 2005; 17: 67–69.

Bob R, Leland RM. Treatment of temporomandibular joint ankylosis: A case report. J Can Dent Assoc 2001; 67: 659–63.

Ahlfors E, Larsson. The odontogenic keratocyst: a benign cystic tumor? J Oral Maxillofac Surg 1984; 42(1): 10–19. https://doi.org/10.1016/0278-2391(84)90390-2

Haring JI, Van Dis ML. Odontogenic keratocysts; a clinical, radiographic and histopathologic study. Oral Surg Oral Med Oral Pathol 1988; 66: 145-153.

Cohen MM. Nevoid basal cell carcinoma syndrome: molecular biology and new hypotheses. Int J Oral Maxillofac Surg 1999; 28(3): 216–223. https://doi.org/10.1016/S09015027(99)80142-8

Taipale J, Chen JK, Cooper MK, et al. Effects of oncogenic mutation in Smoothened and Patched can be reversed by cyclopamine. Nature 2000; 406(6799):1005–1009. https://doi.org/10.1038/35023008

Zhang L, Sun ZJ, Zhao YF, Bian Z. Inhibition of SHH signaling pathway: molecular treatment strategy of odontogenic keratocyst. Med Hypotheses 2006; 67(5):1242–1244. Epub 2006 June 27. https://doi.org/10.1016/j.mehy.2006.04.062

Iwai T. Use of methylene blue for precise peripheral ostectomy of keratocystic odontogenic tumor, British Journal of Oral and Maxillofacial Surgery. 2011; 49: e84–e8. https://doi.org/10.1016/j.bjoms.2011.02.008


Refbacks

  • There are currently no refbacks.