Güven O
University of Ankara, School of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey.
Auris Nasus Larynx. 2000 Jan;27(1):27-33. doi: 10.1016/s0385-8146(99)00045-0.
Temporomandibular joint (TMJ) ankylosis results from trauma, infection and inadequate surgical treatment of the condylary area. Many techniques for treatment have been described so far. However, none of them gave uniformly successful results. A limited range of intrinsical opening due to relapse, loss of vertical height of the affected ramus, foreign body reactions and reankylosis are expected complications. However, wide bone resection, the use of interpositional spacer, insensitive and aggressive physiotherapy immediately after the operation are the basic principles as agreed by many authors. In this article, a review of the historical background of the treatment has been discussed.
A clinical and retrospective evaluation of 42 patients treated for this disorder showed that 89% of all patients had unilaterally and 11% had bilateral ankylosis. From the viewpoint of the techniques we used, patients fell into three groups. In two groups, two different type of spacers were used, and in the third group gap arthroplasty were performed for the treatment of TMJ ankylosis.
Our results revealed a predominance of traumatic aetiology. The highest incidence was between the ages of 11 and 20. A total of 45.24% of the patients were treated by interpositional arthroplasty by using acrylic spacer, 11.90% of the patients by sylastic sheet used as an interpositional material and the rest of the cases (42.86%) were treated only by gap arthroplasty.
The advantages of the spherical acrylic spacer and gap arthroplasty were discussed. The advantages of the techniques are, shorter operating time, and more importantly its very low cost.
颞下颌关节强直由创伤、感染以及髁突区手术治疗不当引起。目前已描述了多种治疗技术。然而,它们均未取得一致的成功结果。因复发导致的固有开口范围受限、患侧升支垂直高度丧失、异物反应和再强直是预期的并发症。然而,广泛的骨切除、使用植入间隔物、术后立即进行不敏感且积极的物理治疗是许多作者认同的基本原则。本文对该治疗的历史背景进行了综述。
对42例接受该疾病治疗的患者进行临床和回顾性评估,结果显示所有患者中89%为单侧强直,11%为双侧强直。从我们使用的技术角度来看,患者分为三组。两组使用了两种不同类型的间隔物,第三组采用间隙关节成形术治疗颞下颌关节强直。
我们的结果显示创伤性病因占主导。最高发病率在11至20岁之间。共有45.24%的患者采用丙烯酸间隔物进行植入关节成形术治疗,11.90%的患者使用硅橡胶片作为植入材料,其余病例(42.86%)仅采用间隙关节成形术治疗。
讨论了球形丙烯酸间隔物和间隙关节成形术的优点。这些技术的优点是手术时间短,更重要的是成本非常低。