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颞下颌关节强直患者下颌骨不对称矫正手术技术的比较

Comparison of Surgical Techniques for Correction of Mandibular Asymmetry in TMJ Ankylosis Patients.

作者信息

Mansuri Samir, Hemavathy S, Sri Sasank Tejaswee Annaluru, Pappu Lakshmi Manasa, Thomas Harvey, Bhuyan Lipsa, Gulia Sunil Kumar

机构信息

Consultant Oral and Maxillofacial Surgeon, Ahmedabad, Gujarat, India.

Department of Oral and Maxillofacial Surgery, Nandha Dental College and Hospital, Perundurai, Erode, Tamil Nadu, India.

出版信息

J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2363-S2365. doi: 10.4103/jpbs.jpbs_304_24. Epub 2024 Jun 7.

Abstract

BACKGROUND

Temporomandibular joint (TMJ) ankylosis frequently results in mandibular asymmetry, which impairs an affected person's ability to function and look good. Because of the intricacy of TMJ ankylosis and the variety of surgical procedures available, correcting mandibular asymmetry surgically can be difficult.

METHODS

Patients with mandibular asymmetry and TMJ ankylosis who had surgery at a tertiary care facility between certain periods were the subject of a retrospective investigation. Medical records were used to gather information on patient demographics, pre-operative imaging, surgical methods, and post-operative results. Surgical methods included condylectomy with or without reconstruction, joint reconstruction with or without orthognathic surgery, and unilateral or bilateral mandibular distraction osteogenesis (MDO). Occlusion, patient-reported results, and facial symmetry made up the evaluation criteria.

FINDINGS

The study had a total of 50 patients, with different surgical method distributions. Comparing unilateral and bilateral MDO to condylectomy and joint reconstruction, notable gains in face symmetry and occlusion were seen. The largest complication rate was seen with condylectomy, mostly from recurrence and device-related issues, albeit the rates of other procedures varied as well.

CONCLUSION

In conclusion, customized treatment planning is necessary for the correction of mandibular asymmetry in individuals with TMJ ankylosis. Although mandibular distraction osteogenesis produces better results for occlusion and facial symmetry, it is crucial to carefully weigh the risks involved. While still feasible treatments, condylectomy and joint reconstruction require strict monitoring for any consequences. In order to enhance patient care in this difficult patient group, future research should concentrate on improving treatment procedures and long-term results.

摘要

背景

颞下颌关节(TMJ)强直常导致下颌不对称,这会损害患者的功能和外貌。由于TMJ强直的复杂性以及可用手术方法的多样性,通过手术纠正下颌不对称可能具有挑战性。

方法

对特定时期内在三级医疗机构接受手术的下颌不对称和TMJ强直患者进行回顾性研究。利用病历收集患者人口统计学、术前影像学、手术方法和术后结果等信息。手术方法包括有或无重建的髁突切除术、有或无正颌手术的关节重建以及单侧或双侧下颌骨牵张成骨术(MDO)。评估标准包括咬合、患者报告结果和面部对称性。

结果

该研究共有50例患者,手术方法分布各异。将单侧和双侧MDO与髁突切除术和关节重建进行比较,发现面部对称性和咬合有显著改善。髁突切除术的并发症发生率最高,主要源于复发和与器械相关的问题,尽管其他手术的发生率也有所不同。

结论

总之,对于TMJ强直患者下颌不对称的矫正,需要定制治疗方案。虽然下颌骨牵张成骨术在咬合和面部对称性方面产生更好的效果,但仔细权衡其中涉及的风险至关重要。尽管髁突切除术和关节重建仍是可行的治疗方法,但需要严格监测任何后果。为了改善这一困难患者群体的护理,未来研究应专注于改进治疗程序和长期结果。

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Total joint prosthesis for ankylosis after multiples condylar traumas.用于多发性髁突创伤后关节强直的全关节假体。
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Temporomandibular Joint Gap Arthroplasty in Cats.猫颞下颌关节间隙关节成形术
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