A New Technique for Arthroscopic Discectomy of the Temporomandibular Joint Disc Perforation: A Technical Note.

Disc perforation represents the result of the degenerative process in joint structures that may lead to pain, joint noise, restricted mouth opening, osteoarthritis, and even dentofacial anomalies. Even though discectomy has proven benefits, with promising outcomes reported, it is mainly described using an open approach. While some arthroscopic techniques have been published, they are limited to managing perforation, edge widening, and inflammation treatment and do not describe complete disc removal. We describe a novel step-by-step arthroscopic discectomy technique utilizing two operative cannulas that completely remove nonfunctional cartilaginous tissue.

Intraoperative complications in temporomandibular joint arthroscopy: A retrospective observational analysis of 899 arthroscopies.

This study aims to describe intraoperative complications in temporomandibular joint arthroscopy in patients with Wilkes stage II, III y IV. An analytic observational retrospective study. Inclusion criteria were patients who had no improvement with conservative treatment diagnosed as Wilkes II stage to Wilkes stage IV, and no previous TMJ surgery. Exclusion criteria were disc perforation observed by arthroscopy. Data collected from 458 patients (899 arthroscopies). Of this population, 772 (85.8%) arthroscopies correspond to women, and 127 men (14.1%). Of the sample evaluated, 368 (40.9%) were arthroscopic without discopexy, and 531 (59%) were arthroscopic with discopexy using resorbable pins. In total, 330 complications (36.7%) were found, of which 293 (32.5%) were implicated with iatrogenic damage to the anatomy, and 36 (4%) were associated with some instrument failure. Of this total number of complications, 191 (51.9%) of 386 corresponded to the arthroscopy without discopexy group and 138 (25.9%) of 531 corresponded to the arthroscopy with discopexy group. These study data suggest that the main complications were irrigation fluid extravasation (p = 0.000), and intra-articular bleeding (p = 0.001) followed by pin problems (p = 0.001) in cases of arthroscopies with discopexy. Within the limitations of the study it seems that the learning curve has an important influence on the occurrence of complications. At the beginning of the learning curve, complications are more related to anatomy. Afterwards, the rate of complications decreases but they are more related to the instruments used in advanced techniques. Therefore, proper training and a wide learning curve can reduce the risk of complications and if any occur, more timely management could be given.

Long-term clinical outcomes of arthroscopic discopexy with resorbable pins.

INTRODUCTION: Discopexy using resorbable pins is an arthroscopic technique to treat internal derangement of the TMJ, restoring the normal relationship between disc, condyle, and temporal bone. The objective of our study was to assess the 5-year clinical outcome of a series of patients treated with this technique. METHODS: A study was conducted on a series of patients who underwent arthroscopic discopexy using resorbable pins between January 2007 and February 2018. All the patients were refractory to conservative treatment and classified as Wilkes stage III. Clinical data were recorded at 1-year, 3-year, and 5-year visits. Pre- and postoperative evaluation parameters were: joint pain (VAS scale), mandibular movements (mm), and articular locking and clicking. RESULTS: The study included 33 patients and the technique was performed in 38 joints. Mouth opening increased significantly with each visit after surgery compared with preoperative scores (mean value of 10.65 mm, p < 0.001), with the mean value increasing significantly at the 5-year visit in relation to the mean value obtained at the 3-year visit. Patients reported significant decreases in pain after surgery, obtaining VAS values of under 10 at the 5-year visit (mean improvement of 56.95 points, p < 0.001). CONCLUSIONS: Discopexy using resorbable pins resulted in a good and stable clinical outcome at the long-term follow-up.

[Electrostimulation for the treatment of dry mouth].

Xerostomia is a very common condition, which not only involves dry mouth feeling, but can also lead to psychosocial distress, impaired quality of life, and complications, such as dental caries and oral candidiasis. It is generally induced by hypofunction of salivary glands, which has a wide variety of etiologies, such as Sjögren's syndrome, radiotherapy to the head and neck and side effects of medications. Current therapies rely on saliva substitutes and pharmacological stimulation of the parasympathetic system. These treatment modalities are somewhat limited by their short-term efficacy, high cost and drug interactions or other adverse effects. Local transcutaneous or permucosal electrostimulation in areas close to the nerves participating in the salivary autonomic reflex has been found to increase salivary secretion in animal and clinical experiments and to relieve symptoms of dry mouth in patients with salivary gland hypofunction. This concept is reviewed to update the readers on the current status and potential of intraoral miniature electrostimulating devices. They offer promise as an optional safe and non-chemical treatment of xerostomia.

Biotechnological advances in neuro-electro-stimulation for the treatment ofhyposalivation and xerostomia

Treatment of xerostomia is a common clinical challenge in the oral medicine practice. Although some treatmentshave been used to improve the symptoms of xerostomia, none is completely satisfactory for the patients who sufferof this alteration. In the last years non-pharmacological treatments based on electro-stimulation for the treatmentof xerostomia have been developed. This review is aimed at presenting new developments for the treatmentof xerostomia, applying neuro-electro-stimulation by miniaturized intra-oral electro-stimulators. These devicesincrease salivary secretion and improve symptoms of oral dryness. Their effect is obtained by means of stimulationof the lingual nerve, in whose proximity the electrodes of the apparatus are placed. The objective of thismechanism is both to directly stimulate the salivary glands controlled by that nerve and to enhance the salivaryreflex. Clinical studies have been carried out that have demonstrated the wetting effect of the method describedin this article (AU)

Discusión del artículo “Complicaciones de los tornillos de bloqueo intermaxilar en el tratamiento de las fracturas mandibulares” / Discussion of the article “Complications of self-tapping bone screws for maxillomandibular fixation in the treatment of jaw fracture”

No disponible

No disponible

Condromatosis sinovial de la articulación temporomandibular / Synovial chondromatosis of the temporomandibular joint

No disponible

Odontoameloblastoma: Descripción de un caso y revisión de la literatura / Odontoameloblastoma: A case report and a review of the literature

El odontoameloblastoma (OA) es un tumor odontogénico mixto extremadamente raro que aparece en los huesos maxilares y que presenta tanto componentes epiteliales como mesenquimales. El término odontoameloblastoma fue incluido en la clasificación de 1971 de la OMS. Tan solo 23 casos bien documentados han sido publicados. Debido a su rareza, existe controversia en cuanto al tratamiento de este tumor. Presentamos un nuevo caso de OA que afecta a la mandíbula y simula un odontoma compuesto, así como una breve revisión de la literatura (AU)

Odontoameloblastoma (OA) is an extremely rare mixed odontogenic tumor appearing within the maxillary bone, with both epithelial and mesenchymal components. The term odontoameloblastoma (OA) was included in the 1971’s WHO classification. Only 23 well-documented cases have been reported in the medical literature. Because of their rarity, controversy exists in the treatment of this tumor. We present a new case of OA involving the mandible mimicking a compound odontoma and a brief review of the related literatura (AU)

Odontoameloblastoma: a case report and a review of the literature.

Odontoameloblastoma (OA) is an extremely rare mixed odontogenic tumor appearing within the maxillary bone, with both epithelial and mesenchymal components. The term odontoameloblastoma (OA) was included in the 1971 WHO classification. Only 23 well-documented cases have been reported in the medical literature. Because of their rarity, controversy exists in the treatment of this tumor. We present a new case of OA involving the mandible mimicking a compound odontoma and a brief review of the related literature.

¿Es necesario un nuevo sistema de acreditación de FMC? / Is necessary a new system of Continuing Medical Education accreditation?

No disponible

Ameloblastic fibroma of the mandible. Report of two cases.

The ameloblastic fibroma (AF)-ameloblastic fibro-odontoma (AFO), is an uncommon benign mixed odontogenic tumor (epithelial and mesenchymal), that represents the 2% of all odontogenic tumors. It usually appears in the mandible and in the posterior segments of young patients without gender predilection, and sometimes is associated with an impacted tooth. The classification of the WHO includes it in the subtype of odontogenic tumors with a defined histologic features. The AF and the AFO are considered as an unique entity as they are variations of the same tumor, only distinct for the presence of an odontoma in the case of the AFO. Surgical conservative treatment with excision followed by curettage seems to be the most appropriate therapeutic option. The objective of this paper is to report two cases of this tumor, to make a brief review of the literature and its differential diagnosis, to analyse its clinical and histologic features and the therapeutic option.

Artrocentesis de la articulación temporomandibular: indicaciones, técnica quirúrgica y resultados / Arthrocentesis of the temporomandibular joint: Indications, surgical technique and results

Introducción: la articulación témporomandibular, es la única articulación del cuerpo humano que funciona simultáneamente de manera bilateral En la actualidad el bloqueo discal puede ser tratado mediante artrocentesis, intervención de cirugía menor que puede ser llevada a cabo bajo anestesia local de manera ambulatoria. Obierivos: el objetivo del presente artículo es mostrar la técnica quirúrgica empleada Además se expondrán las indicaciones, contraindicaciones y posibles complicaciones. Material y metodo, estudio retrospectivo sobre 36 pacientes en los que se realizo 37 artrocentesis. El seguimiento medio fue de 18,34 meses. Resultados y discusión: la artrocentesis fue efectiva en el 100 por ciento de los casos, con una mejoría de los movimientos mandibulares y una disminución del dolor objetivado mediante una Escala Visual Analógica Se detectaron complicaciones en 12 casos. Conclusiones hoy en día la artrocentesis de la ATM parece ser una técnica válida para el tratamiento de los bloqueos discales agudos de la articulación témporomadibular (AU)