Temporomandibular joint (TMJ) ankylosis compromises essential functions such as chewing, phonation, and breathing. Surgical treatment aims to restore mandibular mobility and prevent the recurrence of joint fusion. This article describes a technical variation based on Puricelli biconvex arthroplasty, using surgical cement, screw fixation, and 3D-printed cutting guides based on virtual planning, allowing for greater precision in joint reconstruction. In this work, we present the step-by-step process used in the customization of cutting guides, virtual planning, and the production of the interposition material with PMMA associated with fixation with titanium screws as a hybrid method for the treatment of recurrent TMJ ankylosis. This reported technique is demonstrated to be reproducible, low-cost, and effective.

Introduction and importance: The aneurysmal bone cyst (ABC) is an expansive, destructive, non-odontogenic, and benign bone lesion characterized by spaces filled with blood, typically affecting the elongated bones and spine, with a low incidence in the maxillofacial region. The pathogenesis may occur due to prior or pathological trauma, arteriovenous malformation, secondary association with a pre-existing bone process, such as giant cell tumor, ossifying fibroma, and bone dysplasia, or even genetic alterations. Managing an ABC involves different methods. The preferred treatment is surgical resection for the complete removal of the lesion, thereby reducing the recurrence rate. Case presentation: This study reports a rare case of two secondary ABCs of the mandible arising from pre-existing fibrous dysplasia, detailing the surgical management and recurrence over a 9-year follow-up period. Clinical discussion: This report highlights the clinical, radiological, and histopathological characteristics of mandibular ABCs and emphasizes the importance of accurate diagnosis and comprehensive surgical management to prevent recurrence. Conclusion: The case underscores the diagnostic challenges in differentiating primary ABCs from secondary lesions arising within other fibro-osseous conditions, as well as the need for long-term follow-up to monitor potential relapse.

Introdução: O contorno cervical inadequado é uma das principais queixas estéticas de pacientes que buscam rejuvenescimento facial. Abordagens clássicas para lifting cervical são frequentemente invasivas, com incisões extensas e necessidade de remoção de pele. Objetivo: Descrever uma técnica sistemática de Lifting Cervical Minimamente Invasivo (LCMI) realizada por única incisão submentual, sem ressecção cutânea, destacando indicações, técnica cirúrgica passo a passo e resultados estéticos. Relato de caso: Foi conduzida descrição técnica detalhada baseada na experiência clínica e da literatura. O procedimento envolve marcação anatômica criteriosa, dissecção das camadas profundas, lipectomia subplatismal, manipulação das glândulas submandibulares quando indicado, miotomia parcial do digástrico, fasciotomia peri-hióidea e platismoplastia anterior, sem necessidade de ressecção de pele. Também são reportados casos clínicos. Conclusão: O LCMI é uma opção previsível e reprodutível para pacientes jovens e de meia-idade com excesso de volume cervical e boa qualidade de pele, produzindo resultados consistentes e cicatriz discretamente localizada na região submentual.

Objectives: The aim of this study was to compare the stiffness-related mechanical response and peak von Mises stress distribution of low-profile 2.4 mm mandibular reconstruction systems (a conventional reconstruction plate, a 3D grid-type plate, and a customized plate) in a virtual atrophic mandible model with a 5 cm segmental defect. Materials and Methods: A CT-based three-dimensional mandible model was created and instrumented with three plate configurations (G1–G3). Linear static finite element analyses were performed under a 300-N masticatory load combined with literature-based muscle force vectors. Peak von Mises stresses were recorded for plates and screws, and the locations of maximum stress concentration were identified. Results: Peak plate stress was highest in the conventional reconstruction plate (G1: 695.5 MPa), followed by the 3D grid-type plate (G2: 595.6 MPa), and lowest in the customized plate (G3: 185.2 MPa). The peak screw stress was 692.9 MPa (G1), 898.0 MPa (G2), and 595.6 MPa (G3). The 3D grid-type plate increased construct stiffness but shifted stress concentration toward the mandibular angle and adjacent screws, whereas the customized plate reduced the peak plate stress and limited the extent of the high-stress region across the defect. Conclusions: Within the limitations of a linear static FEA (stiffness/stress distribution rather than failure load or fatigue resistance), the customized plate (G3) demonstrated the most favorable biomechanical performance (lowest peak plate stress). The 3D grid-type plate (G2) reduced peak plate stress compared with the conventional design (G1) but produced the highest peak screw stress. Practical considerations such as manufacturing lead time and resource requirements may favor off-the-shelf plates; however, a formal cost or operative-time analysis was not performed.

Background: Mentoplasty plays a central role in facial harmony, particularly in the correction of chin asymmetries. Advances in digital planning and three-dimensional (3D) printing have enabled the development of patient-specific surgical guides; however, their clinical implementation in public healthcare settings remains limited by workflow complexity and accessibility. Methods: This case series describes three patients who underwent asymmetric mentoplasty using customized, in-house-manufactured 3D-printed cutting and positioning guides. Virtual surgical planning was performed using cone-beam computed tomography (CBCT) data, followed by guide design and fabrication through an in-house digital workflow. Postoperative CBCT was used for descriptive assessment of the correspondence between planned and achieved chin positions using predefined linear reference points. Results: Across the three cases, postoperative CBCT analysis demonstrated encouraging agreement between virtual planning and achieved surgical outcomes. The customized guides facilitated accurate transfer of the planned osteotomy and chin positioning in both symmetric and asymmetric movements. No major intraoperative or postoperative complications were observed. Guide fabrication required low material consumption, enabling rapid in-house production with minimal direct material cost. Conclusions: Within the limitations of a small case series, the proposed in-house digital workflow demonstrated technical feasibility and encouraging agreement between planned and achieved chin positioning in selected asymmetric mentoplasty cases. Further studies with larger samples and standardized accuracy assessment methods are required to confirm these preliminary observations.

Background: Facial asymmetry affecting the mandibular contour may significantly impact facial harmony even in patients with stable occlusion. Although orthognathic surgery remains the standard for skeletal correction, it carries substantial morbidity. In selected cases, contour-focused approaches can achieve meaningful esthetic improvement with reduced surgical burden. Objective: To describe the virtual surgical planning (VSP) workflow and clinical outcome of a unilateral Wing osteotomy for mandibular contour asymmetry. Case presentation: A 24-year-old woman presented with left-sided mandibular contour deficiency and facial asymmetry, despite stable Class I occlusion and preserved function. VSP with contralateral mirroring guided the design of the osteotomy and fabrication of a stereolithographic model and patient-specific cutting guide. Surgery was performed through a tunnelized mandibular approach using a 702 bur and reciprocating saw. Fixation was achieved with pre-bent 2.0 plates adapted to the 3D model, and Bio-Oss Collagen was interposed within the osteotomy gap. Occlusion and mental nerve function were preserved. Results: Postoperatively, the patient demonstrated improved facial symmetry, uneventful healing, preserved long-term neurosensory function, and high esthetic satisfaction. Conclusions: Unilateral Wing osteotomy guided by VSP and patient-specific instrumentation is a predictable, minimally invasive alternative to bimaxillary orthognathic surgery with genioplasty in selected patients presenting contour-focused asymmetry and stable occlusion. This case highlights a rare, underreported application of the technique.