RESUMO
Congenital epulis is a rare benign soft tissue lesion that occurs exclusively in neonates and usually develops from the alveolar mucosa at the frontal region of the maxilla. Lesions may be sessile or pedunculated, normal in color or reddish and vary in size from a few millimeters to a few centimeters. Although spontaneous regression has also been reported, surgical excision is indicated for large tumors that may obstruct the airway and make feeding the child difficult. In this case report, we present a rare case of congenital epulis involving the right side of the maxillary alveolar mucosa in a neonate delivered vaginally at Dhulikhel Hospital, Kavreplanchok, Nepal. The lesion was surgically removed by electrocautery, and histologic examination confirmed the clinical diagnosis of congenital epulis. No complications occurred after surgery, and when the child was examined 6 months later, no evidence of recurrence noticed.
RESUMO
Total temporomandibular joint replacement (TMJR) is a surgical procedure in which end-stage temporomandibular joint disorders are replaced with an alloplastic prosthesis between the mandible and the base of the skull when autogenous grafts are inadvisable. These alloplastic prostheses may be available as stock or custom-made prostheses consisting of the mandibular condyle and glenoid fossa components. Although the first total temporomandibular joint prosthesis was used in the 1960s, we present the case of a 20-year-old female patient, probably the first case of total temporomandibular joint arthroplasty in Nepal, performed at Dhulikhel Hospital in Kavrepalanchok. The patient underwent bilateral TMJR with a custom joint prosthesis for recurrent TMJ ankylosis. Postoperatively, the patient noticed significant improvements in mouth opening, chewing ability, facial esthetics and, most importantly, her self-esteem and confidence.