Copyright © 2015 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited. variables. Time also plays an important role: our first suspicion was for a malignant mass as the neoformation became bulky in dimen- sions in few weeks. The recurrency is another matter of interest: oral osteoma has not been reported to recur after proper surgery, differently with oral osteoblastoma that may recur after complete resection, also many years later. 6 The interesting presentation of this case should be considered in literature as only few authors reported peripheral osteoma associ- ated with teeth. 5 With regard to the case we reported, the volume (24  10 mm) and the fast growth after the third-molar extraction are noteworthy, too. Surgical removal of the entire mass along with the teeth of interest should be performed to ensure complete removal and to avoid recurrence. Prolonged follow-up also plays an important role. Removable dental prosthesis should be preferred to dental implants for the first years after surgery. Aboh Ikenna Valentine, MD, PhD Chisci Glauco, DDS Gennaro Paolo, MD, PhD Department of Maxillofacial Surgery University of Siena Siena, Italy goez@libero.it Gabriele Guido, MD Cascino Flavia, MD Iannetti Giorgio, MD, PhD Department of Maxillofacial Surgery ‘‘Sapienza’’ University of Rome Rome, Italy REFERENCES 1. Farman AG, Nortje CJ, Grotepass F. Periosteal benign osteoblastoma of the mandible. Report of a case and review of the literature pertaining to benign osteoblastic neoplasm of the jaws. Br J Oral Surg 1976;14: 12–22 2. Rushton MA. An osteoid-osteoma of the mandibular alveolus. Oral Surg Oral Med Oral Pathol 1951;4:86–88 3. Sayan NB, Uc ¸ok C, Karasu HA, et al. Peripheral osteoma of the oral and maxillofacial region: a study of 35 new cases. J Oral Maxillofac Surg 2006;60:1299–1301 4. Badauy C, Carrard V, Rados P, et al. Radiopaque mass of the posterior mandible with lingual expansion. J Oral Maxillofac Surg 2005;65:2498– 2502 5. Mohammed I, Jannan NA, Elrmali A. Osteoid osteoma associated with the teeth: unusual presentation. Int J Oral Maxillofac Surg 2013;42:298–302 6. Rahsepar B, Nikgoo A, Fatemidabar SA. Osteoid osteoma of subcondylar region: case report and review of the literature. J Oral Maxillofac Surg 2009;67:888–893 Histologic Study of the Articular Eminence in Wilkes IV Temporomandibular Joint Disorder Patients Temporomandibular joint dysfunction (TMD) is a relatively usual problem, with a 12% to 87% reported incidence in the population. Disorders affecting this complex structure may manifest as musculo- skeletal alterations, and close to one third of the adult population develop symptoms connected with articular pathology, which are concurrently related to stress, age, sex, and systemic factors. 1,2 Numerous investigations and articles have discussed the anatomy and physiology of the temporomandibular joint (TMJ), but only a few of them have analyzed the histological changes of the diseased joint. The aim of the present research was to determine the microscopic appearance of the articular eminence in patients diagnosed with WilkesIVTMDwhounderwentopenTMJsurgerywitheminectomy. 3 The sample consisted of 10 TMJ surgery patients in whom 15 articular eminences were removed, processed, stained with hema- toxilin-eosin, and analyzed by an oral and maxillofacial pathologist at the Universidad El Bosque School of Dentistry. Patients were operated on from July 2011 to April 2012 at either Hospital Universitario Clı ´nica San Rafael or Hospital Simo ´n Bolı ´var in Bogota ´, Colombia. Eighty percent of patients were women, and 20% were men, with an age average of 29.8 years. Descriptive statistics of the patient sample are shown in Table 1. The studied eminences showed hyperplastic changes and active chondrocytes showing hypermetabolism on the growing center with hyaline cartilage converting into fibrocartilage. A proliferative zone consisting of calcified bone and cartilaginous matrix, basophilic lines of cementation that indicated bone apposition between mature and hyperplastic bone, was demonstrated (Figs. 1 and 2). Histopathologic studies of the different anatomical components of the diseased TMJ are not abundant. In 1997, Bernasconi et al 4 described the clinical and histological findings in the synovial tissues on 10 articular discs of patients with TMD, and they found changes such as adhesions between the surface of the disk and the glenoid eminence or the condylar head in all the cases. Histological examination demonstrated hyperplasia of the synovial tissue with formation of prominent protrusions, increased levels of type B cells, and cells with myofibroblastic characteristics. Mineral precipitates and deposits of calcified tissue were found in 3 cases. They TABLE 1. Descriptive Statistics of Patient Sample (n ¼ 10) Variables Demographics Mean age, y 29.8 Male/female 2/8 Health status ASA I 8 ASA II 2 Clinical findings Chronic TMJ pain 10 Mild 6 Severe 4 Headaches 8 Cervical pain 5 Restricted motion 6 Relapsing condylar luxation 3 Condition Right 2 Left 3 Bilateral 5 MRI findings Anterior disc displacement without reduction 7 Disc thickening 7 Abnormal bone contours 8 ASA indicates American Society of Anesthesiologists; MRI, magnetic resonance imaging. Correspondence The Journal of Craniofacial Surgery  Volume 26, Number 3, May 2015 972 # 2015 Mutaz B. Habal, MD