Cheung Lim K, Zheng Li Wu, Ma Li, Shi Xiao Jian
Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Jul;108(1):32-40. doi: 10.1016/j.tripleo.2009.02.030. Epub 2009 May 17.
This study compared the methods of transport distraction and costochondral graft in reconstruction of temporomandibular joint (TMJ) ankylosis.
Bilateral bony TMJ ankylosis was induced in 12 adult goats. Transport distraction of the mandibular ramus was performed on one side, whereas costochondral graft was performed on the other side. Jaw movements, TMJ healing, condylar remodeling, and recurrence of ankylosis were assessed by clinical, radiological, and histological examinations.
Both transport distraction and costochondral graft established a neo-condyle separating from the pseudo-disc with a joint space. The ankylosis scores were higher in the distraction side in the first 12 weeks. Both techniques showed no significant difference in the calcification scores and recurrence of ankylosis in the long term. The maximal jaw movements in 3 directions returned to the pre-ankylosis stage by both methods.
Distraction osteogenesis is an effective reconstruction method for TMJ ankylosis, matching the gold standard of costochondral grafting.
本研究比较了牵引成骨术和肋软骨移植术在颞下颌关节(TMJ)强直重建中的应用方法。
对12只成年山羊诱导双侧骨性TMJ强直。一侧进行下颌支的牵引成骨术,另一侧进行肋软骨移植术。通过临床、影像学和组织学检查评估下颌运动、TMJ愈合、髁突重塑和强直复发情况。
牵引成骨术和肋软骨移植术均形成了与假关节盘分离且有间隙的新髁突。在最初的12周内,牵引侧的强直评分较高。两种技术在长期钙化评分和强直复发方面均无显著差异。两种方法均可使三个方向的最大下颌运动恢复到强直前阶段。
牵引成骨术是TMJ强直的一种有效重建方法,可与肋软骨移植的金标准相媲美。