Top

Oral and Maxillofacial Surgery

Published in:

01-06-2020 | Case Report

Treatment of calcium pyrophosphate deposition in the temporomandibular joint with resection and simultaneous reconstruction using a custom joint prosthesis

Authors: Ahmad K. Abou-Foul, Nadeem R. Saeed

Published in: Oral and Maxillofacial Surgery | Issue 2/2020

Abstract

Purpose

The authors present a rare case of calcium pyrophosphate deposition disease (CPPD) in the temporomandibular joint (TMJ), successfully treated with complete resection and immediate reconstruction using a custom-made prosthesis. This one-stage approach has prevented the patient from requiring two surgeries and has proven effective in the management of the condition.

Methods

Our patient, a 56-year-old male, presented with left TMJ pain and trismus. Investigations showed a destructive left TMJ mass, confirmed by biopsy to be tophaceous pseudogout. The treatment involved excising all the affected tissues followed by condylectomy, coronoidectomy, and a total TMJ replacement. The patient recovered well from surgery with good mouth opening.

Results

CPPD disease is a metabolic arthropathy of poorly understood aetiology. Management options vary from conservative non-surgical to surgical treatment depending on the severity.

Conclusion

This case demonstrates the feasibility of a one-stage procedure with reconstruction using a custom-made prosthesis and virtual planning.

Available only for authorised users

Greaves S, Fordyce A (2002) Bilateral temporomandibular joint pseudogout. Br Dent J 192:25. https://doi.org/10.1038/sj.bdj.4801279 CrossRefPubMed

Zweifel D, Ettlin D, Schuknecht B, Obwegeser J (2012) Tophaceous calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint: the preferential site? J Oral Maxillofac Surg 70(1):60–67. https://doi.org/10.1016/j.joms.2011.06.207 CrossRefPubMed

Laviv A, Sadow PM, Keith DA (2015) Pseudogout in the temporomandibular joint with imaging, arthroscopic, operative, and pathologic findings. Report of an unusual case. J Oral Maxillofac Surg 73(6):1106–1112. https://doi.org/10.1016/j.joms.2014.12.041 CrossRefPubMed

Sklenicka S, Dierks EJ, Jarmin J, Miles C (2011) Pseudogout of the temporomandibular joint: an uncommon cause of temporomandibular joint pain and swelling. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 111(6):709–714. https://doi.org/10.1016/j.tripleo.2010.07.018 CrossRefPubMed

Kathju S, Cohen R, Lasko LA, Aynechi M, Dattilo DJ (2010) Pseudogout of the temporomandibular joint: immediate reconstruction with total joint arthroplasty. Head Neck 32(3):406–410. https://doi.org/10.1002/hed.21074 CrossRefPubMed

Rosenthal AK, Ryan LM (2016) Calcium pyrophosphate deposition disease. N Engl J Med 374:2575–2584. https://doi.org/10.1056/NEJMra1511117 CrossRefPubMedPubMedCentral

Pritzker KP, Phillips H, Luk SC et al (1976) Pseudotumor of temporomandibular joint: destructive calcium pyrophosphate dihydrate arthropathy. J Rheumatol 3:70PubMed

Meul B, Ernestus K, Neugebauer J, Kuebler AC (2005) A case of chronic calcium pyrophosphate dihydrate crystal disease (tophaceous pseudogout) in the temporomandibular joint. Oral Dis 11:113–115. https://doi.org/10.1111/j.1601-0825.2004.01075 CrossRefPubMed

Leandro LF, Ono HY, Loureiro CC, Marinho K, Guevara HA (2013) A ten-year experience and follow-up of three hundred patients fitted with the Biomet/Lorenz Microfixation TMJ replacement system. Int J Oral Maxillofac Surg 42(8):1007–1013. https://doi.org/10.1016/j.ijom.2013.04.018 CrossRefPubMed

10.

Jones RH (2011) Temporomandibular joint reconstruction with total alloplastic joint replacement. Aust Dent J 56:85–91. https://doi.org/10.1111/j.1834-7819.2010.01288 CrossRefPubMed

Title: Treatment of calcium pyrophosphate deposition in the temporomandibular joint with resection and simultaneous reconstruction using a custom joint prosthesis
Authors: Ahmad K. Abou-Foul
Nadeem R. Saeed
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Published in: Oral and Maxillofacial Surgery / Issue 2/2020
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-019-00825-7

At a glance: The STEP trials

Springer Medicine

Treatment of calcium pyrophosphate deposition in the temporomandibular joint with resection and simultaneous reconstruction using a custom joint prosthesis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2020

Success rate and complications of sialendoscopy and sialolithotripsy in patients with parotid sialolithiasis: a systematic review

Optimising the management of concurrent symphyseal/parasymphyseal and bilateral extracapsular condylar fractures using three-dimensional printing

Myeloid sarcoma on the temporal region before the onset of the acute myeloid leukemia: an extremely rare case report

A comparison of tooth-borne and bone-anchored expansion devices in SARME

Adenoid ameloblastoma in the posterior maxilla: a case report and review of the literature

Laser surgery in management of medication-related osteonecrosis of the jaws: a meta-analysis