Zhu Song-Song, Hu Jing, Li Jihua, Luo En, Liang Xinhua, Feng Ge
State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Nov;106(5):662-7. doi: 10.1016/j.tripleo.2008.03.028. Epub 2008 Jul 7.
This article describes the clinical effects of condylar reconstruction by free grafting of autogenous coronoid process in patients with temporomandibular joint (TMJ) ankylosis.
Fifteen cases of uni- or bilateral TMJ ankylosis during a 3-year period from March 2004 to March 2007 were surgically treated, and the average observation period was 22 months. All patients were treated by condylar reconstruction of immediate autogenous coronoid process grafts. Temporal muscle myofascial flaps or native articular disc was used as an interpositional tissue. Clinical examination, radiographs, and photographs were used postoperatively to evaluate the grafts and TMJ function.
Satisfactory mouth opening was achieved in 14 cases, and 1 patient showed signs of reankylosis of the joint (20 mm mouth opening). Radiographic examination showed that bone union occurred between the grafts and the ramus in all cases. Some bony resorption of the grafted coronoid process was observed in all patients, but no occlusal changes were noted.
Satisfactory clinical outcomes are obtained after the condylar reconstruction by free grafting of autogenous coronoid process. Therefore, autogenous coronoid process may be a suitable bone resource for condylar reconstruction in patients with TMJ ankylosis.
本文描述了在颞下颌关节（TMJ）强直患者中通过自体冠突游离移植进行髁突重建的临床效果。
对2004年3月至2007年3月3年间的15例单侧或双侧TMJ强直患者进行手术治疗，平均观察期为22个月。所有患者均采用即刻自体冠突移植进行髁突重建。使用颞肌肌筋膜瓣或天然关节盘作为植入组织。术后通过临床检查、X线片和照片评估移植情况及TMJ功能。
14例患者实现了满意的开口度，1例患者出现关节再次强直迹象（开口度20mm）。X线检查显示所有病例中移植骨与下颌支之间均发生了骨愈合。所有患者均观察到移植冠突有一定程度的骨质吸收，但未发现咬合变化。
通过自体冠突游离移植进行髁突重建后可获得满意的临床效果。因此，自体冠突可能是TMJ强直患者髁突重建的合适骨源。
