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Effect of lavage with injection of sodium hyaluronate for patients with temporomandibular joint dysfunction
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P26
Poster session: Monday, April 26, 1999
44. Effect of Lavage with Injection of Sodium Hyaluronate for Patients with Temporomandibular Joint Dysfunction
Ueok, C., Tuneer, N.., Baykul, T., Aydogan, S., Demiralp, S. Department of Oral and Maxillofacial Surgery, University of Ankara, Turkey Conservative therapy of the intraarticular disorders is not always successful and is often necessary to apply therapy methods that can be defined as non-surgical. In this clinical research, conventional conservative therapy approaches and if required, intraarticular sodium hyaluronate injections were applied on 148 patients that were diagnosed to have anterior disc displacement with reduction. The results of both therapy approaches were evaluated. According to our results, there was a statistically meaningful difference after treatment in mouth opening and pain measurements, but fully treated in only 64.28% of the patients. These results were quite a bit satisfactory for patients that suffer from TMJ dysfunction and could not be treated with standard therapy. Intraarticular sodium hyaluronate injection can be used as a supporting factor for the other treatment techniques in temporomandibular dysfunction.
45. A Surgical Procedure for Treatment of Mandibular Condylar Process Fractures via a Retromandibular Approach
Nagayama, H., Makayama, Y. Department of Oral and Maxillofacial Surgery, Okayama Red Cross General Hospital, Okayama, Japan Introduction In the surgical treatment of fractures of the mandibular condylar process, open or closed reduction is performed depending on the preferences of the surgeon. Repair of the condylar process via the retromandibular approach, which was previously widely employed, is no longer popular due to the technical difficulties associated with this technique and the possibility of facial nerve injury. Aims In our research, we have focused on the development of new methods which provide good access to the fractured region, allow surgery to be completed in the shortest possible time, minimize the risk, and permit the surgical field to be observed directly. Results Specifically, the fracture region can be observed directly in most cases by directly accessing the fracture of the mandibular condylar process, permitting the bone fragments to be easily reduced. In addition, since fixation of bone fragments can be accomplished under direct observation using the lag screw plate system, the surgical procedure can be performed safely and in an extremely short time. Our method has been applied in 9 cases (10 joints) so far; no patients have de-
veloped facial palsy and all report satisfactory mouth open= ing and occlusion. Conclusions 1) Our method allows direct visualization of the surgical field, permitting reduction and fixation of bone fragments to be achieved quickly and easily. 2) Use of the Wuzburg lag screw plate system via the retromandibular approach significantly reduces the time required for the surgical procedure, compared with the conventional method.
46. Treatment of Facial Injuries in Children Based on a Trauma Score
Lazareski, S., Popovski, V..,Grcev, A., Pantchevski, G. Clinic for MaxillofaciaI Surgery, Skopje, R. Macedonia The prevalence of facial trauma between children and adults reveals a disparity consequent to the significant difference between growth influenced skeletal relationships of the facial bones. On the other hand, clinically estimation of facial injuries and possibility of injury to growth centers are essential for proper treatment adoption. We applied trauma score for investigation of the treatment modalities and complication rates. The study included 104 injured patients from 1-14 years of age, treated at the Clinic for Maxillofacial Surgery in Skopje in the period 1988 1997. Separate types and sites of fracture of facial bones patients were classified by the fracture score (modified ISS) and age groups. The choice of the treatment was based on that fracture score and follow-up of the functional and growth consequences was made: According to our findings, a significant number of severe and complicated fractures were in mandibular segments (28%) with age prevalence between 7-12 years. In maxillary fractures, dominant consequences were on tooth bearing segment (12%) and prevalence of uncomplicated fractures on zygomatic region was confirmed. Growth disturbance was predominant after column fractures (17%). The most utilized was conservative treatment with prefabricated appliances and average immobilization of three weeks. Diagrammatic statistic of complication rate was applied. Conclusion Appropriate choice of primary treatment based on adequate trauma score in fractures of facial bones in children is necessary to avoid early complications in bone healing and to reduce late growth disturbances of the facial skeleton.
P26
Poster session: Monday, April 26, 1999
44. Effect of Lavage with Injection of Sodium Hyaluronate for Patients with Temporomandibular Joint Dysfunction
Ueok, C., Tuneer, N.., Baykul, T., Aydogan, S., Demiralp, S. Department of Oral and Maxillofacial Surgery, University of Ankara, Turkey Conservative therapy of the intraarticular disorders is not always successful and is often necessary to apply therapy methods that can be defined as non-surgical. In this clinical research, conventional conservative therapy approaches and if required, intraarticular sodium hyaluronate injections were applied on 148 patients that were diagnosed to have anterior disc displacement with reduction. The results of both therapy approaches were evaluated. According to our results, there was a statistically meaningful difference after treatment in mouth opening and pain measurements, but fully treated in only 64.28% of the patients. These results were quite a bit satisfactory for patients that suffer from TMJ dysfunction and could not be treated with standard therapy. Intraarticular sodium hyaluronate injection can be used as a supporting factor for the other treatment techniques in temporomandibular dysfunction.
45. A Surgical Procedure for Treatment of Mandibular Condylar Process Fractures via a Retromandibular Approach
Nagayama, H., Makayama, Y. Department of Oral and Maxillofacial Surgery, Okayama Red Cross General Hospital, Okayama, Japan Introduction In the surgical treatment of fractures of the mandibular condylar process, open or closed reduction is performed depending on the preferences of the surgeon. Repair of the condylar process via the retromandibular approach, which was previously widely employed, is no longer popular due to the technical difficulties associated with this technique and the possibility of facial nerve injury. Aims In our research, we have focused on the development of new methods which provide good access to the fractured region, allow surgery to be completed in the shortest possible time, minimize the risk, and permit the surgical field to be observed directly. Results Specifically, the fracture region can be observed directly in most cases by directly accessing the fracture of the mandibular condylar process, permitting the bone fragments to be easily reduced. In addition, since fixation of bone fragments can be accomplished under direct observation using the lag screw plate system, the surgical procedure can be performed safely and in an extremely short time. Our method has been applied in 9 cases (10 joints) so far; no patients have de-
veloped facial palsy and all report satisfactory mouth open= ing and occlusion. Conclusions 1) Our method allows direct visualization of the surgical field, permitting reduction and fixation of bone fragments to be achieved quickly and easily. 2) Use of the Wuzburg lag screw plate system via the retromandibular approach significantly reduces the time required for the surgical procedure, compared with the conventional method.
46. Treatment of Facial Injuries in Children Based on a Trauma Score
Lazareski, S., Popovski, V..,Grcev, A., Pantchevski, G. Clinic for MaxillofaciaI Surgery, Skopje, R. Macedonia The prevalence of facial trauma between children and adults reveals a disparity consequent to the significant difference between growth influenced skeletal relationships of the facial bones. On the other hand, clinically estimation of facial injuries and possibility of injury to growth centers are essential for proper treatment adoption. We applied trauma score for investigation of the treatment modalities and complication rates. The study included 104 injured patients from 1-14 years of age, treated at the Clinic for Maxillofacial Surgery in Skopje in the period 1988 1997. Separate types and sites of fracture of facial bones patients were classified by the fracture score (modified ISS) and age groups. The choice of the treatment was based on that fracture score and follow-up of the functional and growth consequences was made: According to our findings, a significant number of severe and complicated fractures were in mandibular segments (28%) with age prevalence between 7-12 years. In maxillary fractures, dominant consequences were on tooth bearing segment (12%) and prevalence of uncomplicated fractures on zygomatic region was confirmed. Growth disturbance was predominant after column fractures (17%). The most utilized was conservative treatment with prefabricated appliances and average immobilization of three weeks. Diagrammatic statistic of complication rate was applied. Conclusion Appropriate choice of primary treatment based on adequate trauma score in fractures of facial bones in children is necessary to avoid early complications in bone healing and to reduce late growth disturbances of the facial skeleton.