Shirani Gholamreza, Arshad Mahnaz, Mahmoudi Xaniar
Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran.
J Dent (Tehran). 2018 Jan;15(1):63-68.
This case report presents a 16-year-old boy with bilateral temporomandibular joint (TMJ) bony ankylosis due to trauma. The patient had undergone several unsuccessful therapeutic surgeries and was experiencing reduced mouth opening, difficulty in eating and speaking, poor oral hygiene, snoring, and depression. Bilateral gap arthroplasty and distraction osteogenesis (DO) were performed. After the surgery, we were able to move the osteodistractors forward and prevent the upward and backward movement of the proximal mandibular segment with the use of our custom-made Sh-device, which allowed bone growth and soft-tissue matching. The mandibular deficiency was treated, and the patient's sleep quality significantly improved after three months. The physical, orthodontic and speech therapies were continued. The facial asymmetry, difficulty in sleeping, eating and speaking, and low self-esteem were completely resolved. At the 8-year follow-up, the patient's condition was satisfactory. The Sh-device can be used as a contemporary treatment modality for TMJ ankylosis.
本病例报告介绍了一名因创伤导致双侧颞下颌关节(TMJ)骨性强直的16岁男孩。该患者曾接受多次治疗性手术但均未成功,目前存在张口受限、进食和说话困难、口腔卫生差、打鼾及抑郁等问题。实施了双侧间隙关节成形术和牵张成骨术(DO)。术后,我们能够通过使用定制的Sh装置向前移动骨牵引器,并防止下颌近端节段向上和向后移动,该装置可促进骨生长和软组织匹配。下颌骨缺损得到治疗,三个月后患者的睡眠质量显著改善。继续进行物理、正畸和言语治疗。面部不对称、睡眠、进食和说话困难以及自卑等问题完全得到解决。在8年的随访中,患者的情况令人满意。Sh装置可作为颞下颌关节强直的一种现代治疗方式。