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SURGICAL MANAGEMENT OF TEMPOROMANDIBULAR JOINT ANKYLOSIS: INITIAL EXPERIENCES

Year 2014, Volume: 17 Issue: 1, 1 - 6, 24.01.2014

Celal Çandırlı , Fatih Taskesen Ezher Dayısoylu

https://doi.org/10.7126/cdj.58140.1008001664

Abstract

Objective: The aim of this study is to introduce our initial clinical experience in the operative management of temporomandibular joint (TMJ) ankylosis.

Study design: This retrospective study assessed 8 patients with TMJ ankylosis who underwent different surgical procedures. Gap arthroplasty with temporalis muscle and fascia flap repositioning was performed in 6 patients, transport distraction osteogenesis was performed to form a neocondyle in one patient and TMJ prosthesis was replaced in one patient. Patients were followed weekly at first month and at months 3rd, 6th, 12th, and 24th postoperatively. Patients were evaluated in terms of maximum interincisal opening and occlusal stability in each appointment.

Results: Mean preoperative Maximum interincisal opening (MIO) of 11 mm (2-14 mm) was improved to 31mm (26-35 mm). All patients had satisfactory mandibular motions 2 years after the operation and reankylosis was not observed in patients.

Conclusion: Radiological and clinical evaluation should be carefully performed to avoid possible intraoperative and postoperative complications in the management of TMJ ankylosis. Consistent with the literature, it was observed that temporalis musculofascial flap repositioning is successful to avoid reankylosis

Keywords

Temporomandibuar joint Ankylosis Gap arthroplasty

References

  • Long X, Li X, Cheng Y, Yang X, Qin L, Qiao Y, Deng M.Preservation of disc for treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg 2005;63(7):897-902.
  • Kaban LB, Bouchard C, Troulis MJ. A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg 2009;67(9):1966-1978
  • Singh V, Dhingra R, Bhagol A. Prospective analysis of temporomandibular joint reconstruction in ankylosis with sternoclavicular graft and buccal fat pad lining. J Oral Maxillofac Surg 2012;70(4):997-1006.
  • Yu H, Shen G, Zhang S, Wang X. Gap arthroplasty combined with distraction osteogenesis in the treatment of unilateral ankylosis of the temporomandibular joint and micrognathia. Br J Oral Maxillofac Surg 2009;47(3):200-204.
  • Katsnelson A, Markiewicz MR, Keith DA, Dodson TB. Operative management of temporomandibular joint ankylosis: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2012;70(3):531-536.
  • Yu HB, Shen GF, Zhang SL, Wang XD, Wang CT, Lin YP. Navigation-guided gap arthroplasty in the treatment of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 2009;38(10):1030-1035.
  • Sadakah AA, Elgazzar RF, Abdelhady AI. Intraoral distraction osteogenesis for the correction of facial deformities following temporomandibular joint ankylosis: a modified technique. Int J Oral Maxillofac Surg. 2006;35(5):399-406.
  • Balcioglu HA, Kilic C, Varol A, Ozan H, Kocabiyik N, Yildirim M. A Morphometric Study of the Maxillary Artery and Lingula in Relation to Mandibular Ramus Osteotomies and TMJ Surgery. Eur J Dent. 2010;4(2):166-170.
  • Candirli C, Celik S. Efficacy of deep subfascial approach to the temporomandibular joint. J Craniofac Surg 2012; 23: 126-129.
  • Chossegros C, Guyot L, Cheynet F, Blanc JL, Cannoni P. Full-thickness skin graft interposition after temporomandibular joint ankylosis surgery. A study of 31 cases. Int J Oral Maxillofac Surg 1999;28(5):330-334.
  • Loveless TP, Bjornland T, Dodson TB, Keith DA. Efficacy of temporomandibular joint ankylosis surgical treatment. J Oral Maxillofac Surg. 2010;68(6):1276-1282.
  • Elgazzar RF, Abdelhady AI, Saad KA, Elshaal MA, Hussain MM, Abdelal SE, Sadakah AA. Treatment modalities of TMJ ankylosis: experience in Delta Nile, Egypt. Int J Oral Maxillofac Surg 2009;39:333-342.
  • Mercuri LG, Ali FA, Woolson R. Outcomes of total alloplastic replacement with periarticular autogenous fat grafting for management of reankylosis of the temporomandibular joint. J Oral Maxillofac Surg 2008;66(9):1794-1803.
  • Singh V, Dhingra R, Sharma B, Bhagol A, Kumar P. Retrospective analysis of use of buccal fat pad as an interpositional graft in temporomandibular joint ankylosis: preliminary study. J Oral Maxillofac Surg 2011;69 (10):2530-2536.
  • Su-Gwan K. Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg 2001;30(3):189-193.
  • Topazian RG. Gap versus interposition arthroplasty for ankylosis of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001 Apr;91(4):388-389.
  • Wolford LM, Bourland TC, Rodrigues D, Perez DE, Limoeiro E. Successful Reconstruction of Nongrowing Hemifacial Microsomia Patients With Unilateral Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery. J Oral Maxillofac Surg 2012;16. [Epub ahead of print]
  • Pearce CS, Cooper C, Speculand B. One stage management of ankylosis of the temporomandibular joint with a custom-made total joint replacement system. Br J Oral Maxillofac Surg 2009;47(7):530-4. Epub 2009 May 30.
  • Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg 2002;60(1):104-10.

Year 2014, Volume: 17 Issue: 1, 1 - 6, 24.01.2014

Celal Çandırlı , Fatih Taskesen Ezher Dayısoylu

https://doi.org/10.7126/cdj.58140.1008001664

Abstract

Amaç:Bu çalışmanın amacı kliniğimizinTemporomandibular eklem ankiloz cerrahisindekicerrahi tecrubelerinin bildirilmesidir.Gereç ve Yöntem: Bu geriye dönük çalışmaTemporomandibular eklem ankilozu olan ve farklımethodlarla tedavi edilen 8 hastayı kapsmaktadır.Altı hastaya gap artroplastisiuygulanmış veberaberinde Temporal kas-fasya flabi transpozeedilmiştir. Bir hastaya neo-kondil oluşturmakamacıyla Distraksiyon osteogenezis ve bir hastayaise eklem protezi uygulanmıştır. Hastalar ilk ay herhafta sonraki 2 senelik dönem içerisinde 3., 6., 12.ve 24. aylarda kliniğimize çağırılmış ve kayıtlarıalınmıştır.Bulgular: Preoperatif ortalama ağız açıklığı 11mm (2-14 mm) iken 2. senenin sonundapostoperatif ortalama maksimum ağız açıklığı 31mm (26-35 mm) ye yükselmiştir. Bütün hastalardatatmin edici mandibular fonksyona ulaşılmıştır vehiç bir hastada nüks eden ankiloz gözlenmemiştir.Sonuçlar: Temporomandibular eklem ankilozcerrahisinde olası operasyon içi ve operasyonsonrası komplikasyonların önlenmesi amacıylahastaların klinik ve radyolojik muayeneleri dikkatlibir şekilde yapılmalıdır. Literatürede uyumlu olarakgap artroplastisi ve beraberinde temporal kas-fasyaflep transpozisyonu Temporomandibular eklemankiloz cerrahi tedavisinde etkili bir yöntem olarakgözlenmiştir.

Keywords

Temporomandibulareklem ankiloz gap artroplastisi.

References

  • Long X, Li X, Cheng Y, Yang X, Qin L, Qiao Y, Deng M.Preservation of disc for treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg 2005;63(7):897-902.
  • Kaban LB, Bouchard C, Troulis MJ. A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg 2009;67(9):1966-1978
  • Singh V, Dhingra R, Bhagol A. Prospective analysis of temporomandibular joint reconstruction in ankylosis with sternoclavicular graft and buccal fat pad lining. J Oral Maxillofac Surg 2012;70(4):997-1006.
  • Yu H, Shen G, Zhang S, Wang X. Gap arthroplasty combined with distraction osteogenesis in the treatment of unilateral ankylosis of the temporomandibular joint and micrognathia. Br J Oral Maxillofac Surg 2009;47(3):200-204.
  • Katsnelson A, Markiewicz MR, Keith DA, Dodson TB. Operative management of temporomandibular joint ankylosis: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2012;70(3):531-536.
  • Yu HB, Shen GF, Zhang SL, Wang XD, Wang CT, Lin YP. Navigation-guided gap arthroplasty in the treatment of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 2009;38(10):1030-1035.
  • Sadakah AA, Elgazzar RF, Abdelhady AI. Intraoral distraction osteogenesis for the correction of facial deformities following temporomandibular joint ankylosis: a modified technique. Int J Oral Maxillofac Surg. 2006;35(5):399-406.
  • Balcioglu HA, Kilic C, Varol A, Ozan H, Kocabiyik N, Yildirim M. A Morphometric Study of the Maxillary Artery and Lingula in Relation to Mandibular Ramus Osteotomies and TMJ Surgery. Eur J Dent. 2010;4(2):166-170.
  • Candirli C, Celik S. Efficacy of deep subfascial approach to the temporomandibular joint. J Craniofac Surg 2012; 23: 126-129.
  • Chossegros C, Guyot L, Cheynet F, Blanc JL, Cannoni P. Full-thickness skin graft interposition after temporomandibular joint ankylosis surgery. A study of 31 cases. Int J Oral Maxillofac Surg 1999;28(5):330-334.
  • Loveless TP, Bjornland T, Dodson TB, Keith DA. Efficacy of temporomandibular joint ankylosis surgical treatment. J Oral Maxillofac Surg. 2010;68(6):1276-1282.
  • Elgazzar RF, Abdelhady AI, Saad KA, Elshaal MA, Hussain MM, Abdelal SE, Sadakah AA. Treatment modalities of TMJ ankylosis: experience in Delta Nile, Egypt. Int J Oral Maxillofac Surg 2009;39:333-342.
  • Mercuri LG, Ali FA, Woolson R. Outcomes of total alloplastic replacement with periarticular autogenous fat grafting for management of reankylosis of the temporomandibular joint. J Oral Maxillofac Surg 2008;66(9):1794-1803.
  • Singh V, Dhingra R, Sharma B, Bhagol A, Kumar P. Retrospective analysis of use of buccal fat pad as an interpositional graft in temporomandibular joint ankylosis: preliminary study. J Oral Maxillofac Surg 2011;69 (10):2530-2536.
  • Su-Gwan K. Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg 2001;30(3):189-193.
  • Topazian RG. Gap versus interposition arthroplasty for ankylosis of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001 Apr;91(4):388-389.
  • Wolford LM, Bourland TC, Rodrigues D, Perez DE, Limoeiro E. Successful Reconstruction of Nongrowing Hemifacial Microsomia Patients With Unilateral Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery. J Oral Maxillofac Surg 2012;16. [Epub ahead of print]
  • Pearce CS, Cooper C, Speculand B. One stage management of ankylosis of the temporomandibular joint with a custom-made total joint replacement system. Br J Oral Maxillofac Surg 2009;47(7):530-4. Epub 2009 May 30.
  • Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg 2002;60(1):104-10.
There are 19 citations in total.

Details

Primary Language English
Journal Section Original Research Articles
Authors

Celal Çandırlı

Fatih Taskesen

Ezher Dayısoylu

Publication Date January 24, 2014
Submission Date July 31, 2012
Published in Issue Year 2014Volume: 17 Issue: 1

Cite

EndNote Çandırlı C, Taskesen F, Dayısoylu E (January 1, 2014) SURGICAL MANAGEMENT OF TEMPOROMANDIBULAR JOINT ANKYLOSIS: INITIAL EXPERIENCES. Cumhuriyet Dental Journal 17 1 1–6.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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