Bhardwaj Yogesh, Arya Saurabh
Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Shimla, Himachal Pradesh, India.
Craniomaxillofac Trauma Reconstr. 2016 Nov;9(4):284-293. doi: 10.1055/s-0036-1584396. Epub 2016 Jul 18.
The purpose of this study was to evaluate the various options of autogenous and alloplastic reconstruction modalities available for posttraumatic temporomandibular joint (TMJ) ankylosis. In a retrospective study of 22 patients, various autogenous/alloplastic materials were used based on type and severity of ankylosis and age of patient. Final outcome of reconstruction was critically evaluated in terms of maximal mouth opening, occlusion, and facial symmetry. Fourteen patients (63.63%) developed TMJ ankylosis due to road traffic accidents and eight patients (36.36%) had a history of fall. The mean age was 15.61 years. The mean preoperative maximum interincisal mouth opening (MIMO) for the entire series was 3.39 mm ± 2.16 and postoperative MIMO was 43.69 mm ± 2.63. Costochondral grafts were used in seven children, whereas titanium reconstruction plate with condylar head was used in five adults and interpositional arthroplasties using temporalis muscle, temporalis fascia, and relocation of the articular disc were used in the rest of the ten patients. We conclude that all these age-specific treatment modalities yield clinically comparable results in terms of postoperative mouth opening and facial symmetry with no evidence of reankylosis in a follow-up ranging from 24 to 96 months.
本研究的目的是评估创伤后颞下颌关节（TMJ）强直可用的自体和异体修复方式的各种选择。在一项对22例患者的回顾性研究中，根据强直的类型和严重程度以及患者年龄使用了各种自体/异体材料。从最大开口度、咬合和面部对称性方面对修复的最终结果进行了严格评估。14例患者（63.63%）因道路交通事故导致TMJ强直，8例患者（36.36%）有跌倒史。平均年龄为15.61岁。整个系列术前平均最大切牙间开口度（MIMO）为3.39 mm±2.16，术后MIMO为43.69 mm±2.63。7名儿童使用了肋软骨移植，5名成人使用了带髁头的钛重建板，其余10名患者使用了颞肌、颞筋膜间置关节成形术和关节盘复位术。我们得出结论，所有这些针对不同年龄的治疗方式在术后开口度和面部对称性方面产生了临床可比的结果，在24至96个月的随访中没有再强直的迹象。
