A anquilose temporomandibular é uma desordem caracterizada pela adesão fibrosa, fibro-óssea ou óssea das  superfícies articulares da articulação temporomandibular (ATM), o que resulta na limitação da abertura  bucal e pode causar dificuldades na higienização oral, mastigação, fala e comprometimento da via aérea  superior. É mais prevalente em homens do que em mulheres, sendo comum na faixa etária entre 20 e 30 anos,  embora possa ocorrer em qualquer idade. Trauma e infecção são os principais fatores etiológicos, mas também  pode estar associada a condições sistêmicas, como a Espondilite Anquilosante. A classificação de Sawhney  divide a anquilose da ATM em quatro tipos, de acordo com o critério de adesão: Tipo I, que envolve uma  fibroadesão, com o processo condilar da mandíbula visível, mas deformado; Tipo II, em que a parte medial do  processo condilar está preservada, mas outras estruturas apresentam alterações; Tipo III, em que a massa  anquilotica envolve o ramo mandibular e o arco zigomático; e Tipo IV, em que a ATM está completamente  envolvida pela massa anquilotica, do ramo mandibular até a base do crânio. 2 O objetivo primário do  tratamento da anquilose temporomandibular é restaurar a função e prevenir a recorrência da anquilose.  Nesse contexto, descrevemos um caso de anquilose unilateral de ATM tratada com remoção do bloco  anquilotico, osteotomia vertical do ramo mandibular ipsilateral e coronoidectomia bilateral, utilizando acessos  intraorais e faciais (ridectomia), visando a recuperação da função mandibular e melhoria da qualidade de vida  do paciente.

In the presented case, we were able to use an alternative, noninvasive form of treatment, which provided our patient with an overall improvement in physical and psychologic aspects.

Fibro-bone lesions (LFO) are defined as a group of lesions characterized by the replacement of normal bone tissue with fibrous connective tissue, of variable cellularity, permeated by a variable amount of mineralized material, whose microscopic appearance may resemble bone, cement or a mixture of both. Among the injuries that make up this group, we can mention: fibrous dysplasia, ossifying fibroma, bone dysplasia and cemento-bone dysplasia. In this case report, we presented a mandibular reconstruction with free autogenous graft from the iliac crest, with the use of stereolithography prototyping, after the surgical treatment of a cemento-ossifying fibroma, as well as to describe the clinical, epidemiological, radiographic characteristics, and histological, the differential diagnosis and the form of treatment of the referred pathology.

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There should be no contrast enhancement. If the diffusion is essential to make the distinction between masses and other lesions for the differential diagnosis. Since the main feature imaging is requested, their signal is high in DWI and ADC images because of the increasing diffusion of molecules. PAC covers the internal carotid artery but it doesn't compress it. Most importantly, it is necessary to see typical suppression of CSF in FLAIR sequences. 6 These radiological features are present in our case.Arachnoid cyst is the main lesion in the differential diagnosis. However, some radiological features easily distinguish it from PAC. Massive erosion or indentation of a petrous apex is not expected. The other diseases in the differential diagnosis of the PAC include benign obstructive lesions of air cells (cholesterol granuloma and mucocele), congenital or acquired cholesteatoma, epidermoid cyst, and apical petrocyte. 4,7 Let's look at the radiological features that may be useful in the differential diagnosis: a signal intensity similar to that of CSF is observed in the case of effusion of petrous air cells, which is a favor in PAC. However, the nondeterioration of the air cells' trabecular structure and the absence of expansion are directing to other differential diagnoses. Cholesterol granuloma has a high signal in T1 WI unlike PAC. The signal of mucocele is similar to PAC in conventional MRI sequences, but signal differences are occurring in FLAIR sequences and DWI. Contrast enhancement is not usually seen in PAC. If contrast enhancement is present, only a very thin rim enhancement is observed. Indeed, there is no contrast enhancement in our case.According to the literature, PAC is accompanied by empty sella in 5% to 35% of the cases. The formation mechanism of the empty sella is similar to PAC's one. Increased intracranial pressure causes enlargement of sella turcica and indentation of the suprasellar cistern to this area. Due to the reasons explained above, since the mechanism is different in unilateral cases, empty sella is expected to occur only in patients with bilateral PAC. However, no study classifies empty sella according to unilateral and bilateral patients. In addition, there are reports about the relationship between PAC and Usher syndrome (a genetic syndrome associated with deafness/hearing loss and retinitis pigmentosa) in the literature. 8 In our patient, sella turcica was broad but there was no evidence of empty sella. Considering the benign clinic of our case, it was thought that the etiologic condition causing PAC probably could not create sufficient pressure for empty sella formation but widened the sella.In our case, a severe headache was the dominant symptom. 9 Usually, no treatment is required for asymptomatic cases. However, in symptomatic ones, there is a complicated treatment process including surgery. 10 CONCLUSIONS Petrous apex cephalocele is a rare type of cephalocele. Our case is one of the first 50 reported cases. Bilateral cases are rarer. They are a different entity from unilater...