Bansal Vishal, Mowar Apoorva, Dubey Prajesh, Bhatnagar Aditi, Bansal Avi
Department of Oral & Maxillofacial Surgery, Subharti Dental College, Swami Vivekanand Subharti University, NH-58, Meeurt By Pass Road, Meerut (Uttar Pradesh) - 250005, India.
Department of Oral & Maxillofacial Surgery, Subharti Dental College, Swami Vivekanand Subharti University, NH-58, Meeurt By Pass Road, Meerut (Uttar Pradesh) - 250005, India.
Br J Oral Maxillofac Surg. 2016 Apr;54(3):280-5. doi: 10.1016/j.bjoms.2016.01.012. Epub 2016 Feb 2.
The aim of this non-randomised investigation was to assess the feasibility of using autogenous grafts (such as coronoid process and the resected ankylotic mass) in reconstruction of the condyle after gap arthroplasty for ankylosis of the temporomandibular joint (TMJ). Sixteen patients (23 joints) operated on between 2007 and 2009 were studied and postoperative measurements of maximum interincisal opening, bite force, range of movement, and infection were recorded. After a mean (SD) follow up of 55 (2.25) months mouth opening improved from 3 (3.84) mm to 33 (1.66) mm in patients treated with coronoid graft, while in patients treated with an ankylotic mass after a mean (SD) follow up of 58 (1.58) months it increased from 4 (2.64) mm to 26 (8.04) mm. Bite force six months postoperatively ranged from 18.25kg/cm(2) - 27.5kg/cm(2) after reconstruction with the coronoid process and 18.5kg/cm(2) - 23.25kg/cm(2) after reconstruction with the ankylotic mass. One patient developed reankylosis postoperatively and another developed infection, in both of which the ankylotic mass had been used. Both were managed successfully. Both the ankylotic mass and the coronoid process gave satisfactory results and seem to be options for reconstruction. However, the coronoid process graft was better than residual ankylotic mass in terms of masticatory efficiency, bite force, and range of movement.
这项非随机研究的目的是评估在颞下颌关节(TMJ)强直间隙关节成形术后使用自体移植物(如冠突和切除的强直块)重建髁突的可行性。对2007年至2009年间接受手术的16例患者(23个关节)进行了研究,并记录了术后最大切牙间开口度、咬合力、活动范围和感染情况的测量结果。在用冠突移植物治疗的患者中,平均(标准差)随访55(2.25)个月后,开口度从3(3.84)毫米改善到33(1.66)毫米;而在用强直块治疗的患者中,平均(标准差)随访58(1.58)个月后,开口度从4(2.64)毫米增加到26(8.04)毫米。术后6个月,用冠突重建后的咬合力范围为18.25kg/cm² - 27.5kg/cm²,用强直块重建后的咬合力范围为18.5kg/cm² - 23.25kg/cm²。1例患者术后发生再强直,另1例发生感染,两者均使用了强直块。两者均成功处理。强直块和冠突均取得了满意的结果,似乎都是重建的选择。然而,在咀嚼效率、咬合力和活动范围方面,冠突移植物优于残留的强直块。