Maxillofac Plast Reconstr Surg.
2018 ;40(1):19. 10.1186/s40902-018-0158-0.
Calcium pyrophosphate dihydrate deposition disease in the temporomandibular joint: diagnosis and treatment
- Affiliations
-
- 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea.
- 2Department of Oral and Maxillofacial Surgery, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea. sok8585@hanmail.net
- 3Gangwon Regional Division, Korea Institute of Industrial Technology, Gangneung 25440, Republic of Korea.
- 4Department of Oral and Maxillofacial Radiology, College of Dentistry, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea.
- KMID: 2431942
- DOI: http://doi.org/10.1186/s40902-018-0158-0
Abstract
- BACKGROUND
Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare disease in the temporomandibular joint (TMJ) space. It forms a calcified crystal mass and induces a limitation of joint movement.
CASE PRESENTATION
The calcified mass in our case was occupied in the left TMJ area and extended to the infratemporal and middle cranial fossa. For a complete excision of this mass, we performed a vertical ramus osteotomy and resected the mass around the mandibular condyle. The calcified mass in the infratemporal fossa was carefully excised, and the segmented mandible was anatomically repositioned. Scanning electronic microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) microanalysis was performed to evaluate the calcified mass. The result of SEM/EDS showed that the crystal mass was completely composed of calcium pyrophosphate dihydrate. This result strongly suggested that the calcified mass was CPDD in the TMJ area.
CONCLUSIONS
CPDD in the TMJ is a rare disease and is difficult to differentially diagnose from other neoplasms. A histological examination and quantitative microanalysis are required to confirm the diagnosis. In our patient, CPDD in the TMJ was successfully removed via the extracorporeal approach. SEM/EDS microanalysis was used for the differential diagnosis.
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