Deffez J P, Ferkadjki L, Brethaux A J, Chauve J, Gross D, Julhes L, Hazen M, Themar P
Service de Stomatologie, Hôpital Robert-Debré, Paris.
Rev Stomatol Chir Maxillofac. 1992;93(4):231-5.
According to the authors, who have an 18-year experience, the treatment of temporomandibular ankylosis in children consists in the resection of the ankylosis block and of the corresponding neck of the condyle, along with the preservation of the capsule and articular disk and a dynamic blockade with the mouth open until the mandibular condyle is completely reconstructed. After witnessing the constitution of ankylosis in a child who was initially examined 3 weeks after the trauma, we were able to carry out a thorough clinicopathological examination of the areas of tissue characterizing incipient ankylosis, both in the condylar cartilage and in the underlying bone. The initial stage produces the progressive emergence of the bony surfaces, which then bear no cartilage. This is osteogenesis as well as cartilage resorption, as evidenced by the presence of neoformed Haversian canals at that level. This is a formal argument in favor of a systematic dynamic blockade with the mouth open in all cases of fresh condylar surface and the menisceal surface of the joint is the best way to prevent ankylosis or malunion.
据有18年经验的作者称,儿童颞下颌关节强直的治疗包括切除强直块和相应的髁突颈部,同时保留关节囊和关节盘,并在开口时进行动态制动,直到下颌髁突完全重建。在一名创伤后3周首次检查的儿童出现关节强直后,我们能够对早期关节强直特征性组织区域进行全面的临床病理检查,包括髁突软骨和下方骨组织。初始阶段会逐渐出现无软骨覆盖的骨面。这是骨生成以及软骨吸收,该水平出现新形成的哈弗斯管可证明这一点。这有力地支持了在所有新鲜髁突表面损伤和关节半月板表面损伤病例中进行系统性开口动态制动,这是预防关节强直或骨不连的最佳方法。