Sagittal position of the temporomandibular joint disc after treatment with an activator: an MRI study

Background: The relation of cause and effect between orthodontic treatment and joint dysfunction, especially disc displacement, is not proved yet. The orthodontic treatment that imposes stress on the temporomandibular joint is the mandibular advance to correct the classes II by mandibular retrognathia. The study aimed to explore the effect of mandibular advancement using rigid activator associated with extra-oral forces on the sagittal position of temporomandibular joint (TMJ) disc.Methods:63 children, 10.6 +/- 1 years old with class II and mandibular retrognathia were selected from primary schools. An imaging magnetic resonance exploration (MRI) was performed on 126 TMJ before treatment (t1) and one year after treatment (t2). The data were analyzed by the Statistical Package for the Social Sciences (SPSS).The error risk αwas 5%. The Friedman's Chi2 Test for paired data was used. The difference p was considered significant if p<0.05.Results: At t2, the discs generally occupied a more anterior position remaining within the bounds of normality and 5 of them have presented a displacement. Conclusion: Overall, after one year of mandibular advancement, the discs have maintained a normal position

Congenital craniopharyngioma: a case report and literature review.

INTRODUCTION: Although craniopharyngiomas are congenital tumors, they are rarely diagnosed in the prenatal or early neonatal period. Sometimes they are very large, debilitating and life-threatening, as in the case discussed here. OBSERVATION: A 21-month-old girl was referred for craniopharyngioma that had been diagnosed at 5 months because of neurologic complications. The pregnancy and birth were considered to be unremarkable. The birth weight was 4 kg, length 53 cm, head circumference 38 cm (n=35±1). Brain CT revealed active hydrocephalus caused by a very large solid, cystic and calcified supra sellar mass. MRI confirmed the process measuring 5 cm in height, multidirectional, diving into pituitary sella, displacing the brainstem. After several resections and reservoir drainage, the patient was blind, hemiparetic and she convulsed frequently. The patient died when she was 2. CONCLUSION: The large head circumference at birth, the size of the tumor, blindness, and hemiparesis observed before the age of 5 months suggested an antenatal process unnoticed because of inadequate gestational monitoring.