Sharma Ravi, Manikandhan R, Sneha P, Parameswaran Anantanarayanan, Kumar J Naveen, Sailer Hermann F
Meenakshi Cleft and Craniofacial Centre, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.
Indian J Dent Res. 2017 May-Jun;28(3):269-274. doi: 10.4103/ijdr.IJDR_292_13.
Management of temporomandibular joint (TMJ) ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis.
Neocondyle distraction was carried out in five patients with TMJ ankylosis following gap arthroplasty. Computed tomogram scans were taken before surgery and 1-year postdistraction for surgical planning and postoperative assessment, respectively. The intraoral distractors (KLS Martin, Jacksonville, FL, USA) were used in this study.
All five patients reported with adequate mouth opening and functional jaw movements. The procedure was well tolerated by all the patients. None of the patients underwent reankylosis following neocondyle distraction.
With proper surgical planning and distraction protocol, neocondyle distraction is an effective and safe technique for TMJ reconstruction and preventing reankylosis.
颞下颌关节(TMJ)强直的治疗是一项具有挑战性且相当艰巨的任务,这是由于其复杂的解剖结构异常及其对颅面结构的后续影响。人们尝试了各种自体移植物和异体材料来创建接近正常的关节,但效果各异。近年来,新髁牵张成骨为颞下颌关节强直的治疗增添了新的维度。本文旨在描述新髁牵张成骨在颞下颌关节强直治疗中的作用。
对5例颞下颌关节强直患者在间隙性关节成形术后进行新髁牵张成骨。分别在手术前和牵张后1年进行计算机断层扫描,用于手术规划和术后评估。本研究使用了口内牵张器(美国佛罗里达州杰克逊维尔市的KLS Martin公司生产)。
所有5例患者均报告张口度足够且下颌功能运动良好。所有患者对该手术耐受性良好。新髁牵张成骨后,无一例患者发生再强直。
通过适当的手术规划和牵张方案,新髁牵张成骨是一种用于颞下颌关节重建和预防再强直的有效且安全的技术。