Rojare Camille, Wojcik Thomas, Coussens Camille, Ferri Joël, Pertuzon Bruno, Raoul Gwénaël
Département Universitaire de Chirurgie Maxillo-Faciale et Stomatologie, Hôpital Roger Salengro, CHU, rue du Pr Émile Laine, 59000 Lille, France - Université Lille Nord de France, UDSL, 59000 Lille, France.
Département Universitaire de Chirurgie Maxillo-Faciale et Stomatologie, Hôpital Roger Salengro, CHU, rue du Pr Émile Laine, 59000 Lille, France - Université Lille Nord de France, UDSL, 59000 Lille, France - Unité INSERM U1008, Médicaments et Biomatériaux à Libération Contrôlée, 59000 Lille, France - Association Internationale de Médecine Orale et Maxillo-Faciale (AIMOM), 7 bis rue de la créativité, 59650 Villeneuve-d'Ascq, France.
Orthod Fr. 2014 Jun;85(2):189-200. doi: 10.1051/orthodfr/2014006. Epub 2014 Jun 16.
This retrospective study aimed to evaluate bone remodeling of temporo-mandibular joints (TMJ) using computed tomography (CT) before and after condylectomy for condylar hyperplasia.
TMJ bone remodeling was studied by comparing the pre and postoperative CT scan of ten patients. Qualitative evaluation was performed by two-dimensional analysis. Three-dimensional analysis superimpositions were done after digital condylar units isolation. Condylar volume modifications were measured and compared on both sides. Lastly, before and after surgery, we studied the radio-clinic correlations.
After surgery, all the operated condyles developed a new cortical bone. We noticed also a thickening of the glenoid fossa. Surgical condylectomy leaded to a 43.5% volume reduction on the operated side and 2.14% on the controlateral side. On the controlateral side, most of abnormalities seen preoperatively disappeared after surgery. For two patients, the condylar resection took away over 80% of the initial volume. For these patients, we observed major radiologic modifications on the controlateral TMJ associated with symptoms of dysfunction. These problems did not worsen their quality of life.
Both TMJ presented with bone remodelling after condylectomy. In condylar hyperplasia, condylectomy provides orthopaedic results on dysmorphia and removal of the pathological prechondroblastic zone. In the future, an earlier detection of this pathology may help the surgeon to treat in childhood. This would limit surgical excision and would avoid important dysmorphia.
本回顾性研究旨在通过计算机断层扫描（CT）评估髁突切除术治疗髁突增生前后颞下颌关节（TMJ）的骨重塑情况。
通过比较10例患者术前和术后的CT扫描来研究TMJ骨重塑。采用二维分析进行定性评估。在数字分离髁突单位后进行三维分析叠加。测量并比较双侧髁突体积的变化。最后，研究手术前后影像学与临床的相关性。
术后，所有手术侧的髁突均形成了新的皮质骨。我们还注意到关节窝增厚。手术切除髁突导致手术侧体积减少43.5%，对侧减少2.14%。在对侧，术前观察到的大多数异常在术后消失。对于2例患者，髁突切除量超过初始体积的80%。对于这些患者，我们在对侧TMJ观察到与功能障碍症状相关的主要影像学改变。这些问题并未恶化他们的生活质量。
髁突切除术后双侧TMJ均出现骨重塑。在髁突增生中，髁突切除术可改善畸形并切除病理性软骨前区。未来，更早地发现这种病理情况可能有助于外科医生在儿童期进行治疗。这将限制手术切除范围并避免严重畸形。
