Department of Oral SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China.
Department of Oral and Cranio-Maxillofacial SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China.
BMC Musculoskelet Disord. 2022 Apr 26;23(1):387. doi: 10.1186/s12891-022-05337-2.
Disc repositioning by Mitek anchors for anterior disc displacement (ADD) combined with orthognathic surgery gained more stable results than when disc repositioning was not performed. But for hypoplastic condyles, the implantation of Mitek anchors may cause condylar resorption. A new disc repositioning technique that sutures the disc to the posterior articular capsule through open incision avoids the implantation of the metal equipment, but the stability when combined with orthognathic surgery is unknown. The purpose of this study was to evaluate the stability of temporomandibular joint (TMJ) disc repositioning by open suturing in patients with hypoplastic condyles when combined with orthographic surgery.
Patients with ADD and jaw deformity from 2017 to 2021 were included. Disc repositioning by either open suturing or mini-screw anchor were performed simultaneously with orthognathic surgery. MRI and CT images before and after operation and at least 6 months follow-ups were taken to evaluate and compare the TMJ disc and jaw stability. ProPlan CMF 1.4 software was used to measure the position of the jaw, condyle and its surface bone changes.
Seventeen patients with 20 hypoplastic condyles were included in the study. Among them, 12 joints had disc repositioning by open suturing and 8 by mini-screw anchor. After an average follow-up of 18.1 months, both the TMJ disc and jaw position were stable in the 2 groups except 2 discs moved anteriorly in each group. The overall condylar bone resorption was 8.3% in the open suturing group and 12.5% in the mini-screw anchor group.
Disc repositioning by open suturing can achieve both TMJ and jaw stability for hypoplastic condyles when combined with orthognathic surgery.
与未行髁突再定位术相比，Mitek 锚钉辅助治疗前牙盘移位（ADD）联合正颌手术可获得更稳定的效果。但是对于发育不良的髁突，Mitek 锚钉的植入可能导致髁突吸收。一种新的盘复位技术，通过开放式切口将盘缝合到后关节囊，避免了金属设备的植入，但与正颌手术联合使用时的稳定性尚不清楚。本研究旨在评估发育不良髁突患者行开放式缝线盘复位术联合正颌手术时 TMJ 盘稳定性。
纳入 2017 年至 2021 年患有 ADD 和颌骨畸形的患者。同时行开放式缝线或微型螺钉锚钉髁突再定位术与正颌手术。在术前、术后及至少 6 个月随访时进行 MRI 和 CT 检查，评估和比较 TMJ 盘和颌骨稳定性。采用 ProPlan CMF 1.4 软件测量颌骨、髁突及其表面骨的位置变化。
本研究共纳入 17 例 20 侧发育不良髁突患者，其中 12 侧采用开放式缝线，8 侧采用微型螺钉锚钉。平均随访 18.1 个月后，两组 TMJ 盘和颌骨位置均稳定，除两组各有 1 个盘向前移位外。开放式缝线组整体髁突骨吸收 8.3%，微型螺钉锚钉组为 12.5%。
与正颌手术联合应用时，开放式缝线髁突再定位术可稳定发育不良髁突的 TMJ 和颌骨。
