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Prevention of fibrosis and heterotopic bone formation around temporomandibular joint by buccal pad of fat treatment outcome in 20 cases
TMJ ary correction of the residual deformities. The study compares the different methods of management. The protocol based on the principles propounded by Kaban et al. have proved to be most useful especially in the prevention of recurrences thus becoming the standard protocol in the armed forces. doi:10.1016/j.ijom.2007.08.383
(VAS) were measured at 15 days, 1 month, 3 months and 6 months for these two groups. Results: Mobility and pain scores were same for the first 15 days. There were significantly decreased pain and increased mouth opening in BPF group at 1 month, 3 months and 6 months. Conclusion: BPF is an effective barrier in preventing fibrosis and heterotopic bone formation and it can be a useful adjunct in preventing reankylosis of joint.
O16.9
doi:10.1016/j.ijom.2007.08.385
Coronoid autograft and switchover coronoids for condylar reconstruction in extensive TMJ ankylosis
O16.11
B. Pappachan Govt. Dental College, Raipur, Chhattisgarh, India A relatively new method of condylar reconstruction with interpositional arthroplasty, in extensive ankylosis is presented. An autogenous graft of coronoid which is reshaped and contoured in the form of condyle is reimplanted and used for condylar reconstruction. In cases of bilateral TMJ ankylosis and in case of open bite due to loss of vertical height of ramus the use of switchover coronoid autograft is effective in maintaining the vertical height and avoiding open bite. doi:10.1016/j.ijom.2007.08.384
O16.10 Prevention of fibrosis and heterotopic bone formation around temporomandibular joint by buccal pad of fat treatment outcome in 20 cases V. Rattan Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India Formation of fibrosis and heterotopic bone formation after temporomandibular joint (TMJ) surgery is a major cause of re-ankylosis. The author has devised a new technique of transposing buccal pad of fat (BPF) to the TMJ. Objective: Purpose of the study was to evaluate efficacy of BPF in preventing fibrosis and heterotopic bone formation and determine its effect on postoperative mobility. Method: Twenty patients in each group, with TMJ ankylosis underwent surgical release with and without BPF transposition around the reconstructed joint. Postoperative mobility and pain scores
Temporomandibular joint replacement using the TMJ concepts custom total joint replacement system Martin Evans12*, B. Speculand12, R. Hensher12, A. Sidebottom12 1University Hospital Birmingham, UK Queens Medical Centre, Nottingham, UK 2Gloucestershire Royal Hospital and Private Practice, London, UK Temporomandibular joint replacement surgery has been carried out in various centres in the UK since 1987. Data collection has been sporadic and piecemeal to date. We have used the TMJ Concepts custom made total joint replacement system since the year 2000 in Gloucester and London and since 2004 in Birmingham and Nottingham. We present our combined experience with 87 patients (133 joints) to date and discuss the stepwise work up of the patients, design factors related to the prosthesis, surgical aspects and our postoperative results. doi:10.1016/j.ijom.2007.08.386
O16.12 TMJ ankylosis—our perspective S. Mohanty Oral & Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India Objectives: Ankylosis of the TMJ is a distressing condition which causes functional debility and facial blemish. Surgical care of these patient constitute a significant bulk of our operating spectrum. Amongst the numerous available surgical options unequivocal superiority of either is still awaited. The aim of this study is to determine the efficacy of treatment philosophy followed at our centre. Materials and methods: This retrospective analysis
1065
of 60 postoperative TMJ ankylosis cases operated over a period of 5 years, attempts to determine the efficacy of prescribed and instituted therapy for these patients. Interpositional arthroplasty (using meniscus and temporalis muscle and fascia) or joint reconstruction (costochondral graft) with or without concomitant coronoidectomy were the surgical procedure performed. A correlation of improvement in mouth opening was made with the type of procedure performed. Associated complications were also noted. Results: The mean postoperative mouth opening was 29 mm; analysis revealed that the improvement in mouth opening was not significantly different among the three groups. No recurrence was observed. The most common postop complication was transient paralysis of frontal branch of CN VII. Postop wound infection was observed in two cases. Conclusion: Impeccably performed surgical procedure and vigorous post-surgical physiotherapy forms the cornerstone of a successful outcome. doi:10.1016/j.ijom.2007.08.387
O16.13 Temporomandibular joint ankylosis— a retrospective analysis of 57 cases P. Sharma*, S. Kumar, A. S. Rana, V. Bansal, G. Jain, A. Vikram Department of Oral & Maxillofacial Surgery, G.G.S.M. Subharti Dental College, Meerut, U.P., India Temporomandibular joint (TMJ) ankylosis is still a fairly common disorder in our country due to want of proper medical care following trauma and a lack of awareness. The present series is a retrospective analysis of 57 TMJ ankylosis patients, who reported to our unit between May 1, 2003 and March 31, 2007.The patients were between 6 years and 60 years in age. Different approaches and various treatment modalities were utilized for treatment. Brisement’s force, condylar shaving, high condylectomy, gap arthroplasty and interpositional arthroplasty with a variety of materials was performed to release the ankylosed joint. We have utilized the costochondral graft in a few cases where we wanted growth to occur. An alloplastic condyle was placed in one patient. Distraction osteogenesis was used for reconstruction of facial deformity in two patients of bilateral ankylosis and one patient of unilateral ankylosis with satisfactory results. No case of permanent
(VAS) were measured at 15 days, 1 month, 3 months and 6 months for these two groups. Results: Mobility and pain scores were same for the first 15 days. There were significantly decreased pain and increased mouth opening in BPF group at 1 month, 3 months and 6 months. Conclusion: BPF is an effective barrier in preventing fibrosis and heterotopic bone formation and it can be a useful adjunct in preventing reankylosis of joint.
O16.9
doi:10.1016/j.ijom.2007.08.385
Coronoid autograft and switchover coronoids for condylar reconstruction in extensive TMJ ankylosis
O16.11
B. Pappachan Govt. Dental College, Raipur, Chhattisgarh, India A relatively new method of condylar reconstruction with interpositional arthroplasty, in extensive ankylosis is presented. An autogenous graft of coronoid which is reshaped and contoured in the form of condyle is reimplanted and used for condylar reconstruction. In cases of bilateral TMJ ankylosis and in case of open bite due to loss of vertical height of ramus the use of switchover coronoid autograft is effective in maintaining the vertical height and avoiding open bite. doi:10.1016/j.ijom.2007.08.384
O16.10 Prevention of fibrosis and heterotopic bone formation around temporomandibular joint by buccal pad of fat treatment outcome in 20 cases V. Rattan Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India Formation of fibrosis and heterotopic bone formation after temporomandibular joint (TMJ) surgery is a major cause of re-ankylosis. The author has devised a new technique of transposing buccal pad of fat (BPF) to the TMJ. Objective: Purpose of the study was to evaluate efficacy of BPF in preventing fibrosis and heterotopic bone formation and determine its effect on postoperative mobility. Method: Twenty patients in each group, with TMJ ankylosis underwent surgical release with and without BPF transposition around the reconstructed joint. Postoperative mobility and pain scores
Temporomandibular joint replacement using the TMJ concepts custom total joint replacement system Martin Evans12*, B. Speculand12, R. Hensher12, A. Sidebottom12 1University Hospital Birmingham, UK Queens Medical Centre, Nottingham, UK 2Gloucestershire Royal Hospital and Private Practice, London, UK Temporomandibular joint replacement surgery has been carried out in various centres in the UK since 1987. Data collection has been sporadic and piecemeal to date. We have used the TMJ Concepts custom made total joint replacement system since the year 2000 in Gloucester and London and since 2004 in Birmingham and Nottingham. We present our combined experience with 87 patients (133 joints) to date and discuss the stepwise work up of the patients, design factors related to the prosthesis, surgical aspects and our postoperative results. doi:10.1016/j.ijom.2007.08.386
O16.12 TMJ ankylosis—our perspective S. Mohanty Oral & Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India Objectives: Ankylosis of the TMJ is a distressing condition which causes functional debility and facial blemish. Surgical care of these patient constitute a significant bulk of our operating spectrum. Amongst the numerous available surgical options unequivocal superiority of either is still awaited. The aim of this study is to determine the efficacy of treatment philosophy followed at our centre. Materials and methods: This retrospective analysis
1065
of 60 postoperative TMJ ankylosis cases operated over a period of 5 years, attempts to determine the efficacy of prescribed and instituted therapy for these patients. Interpositional arthroplasty (using meniscus and temporalis muscle and fascia) or joint reconstruction (costochondral graft) with or without concomitant coronoidectomy were the surgical procedure performed. A correlation of improvement in mouth opening was made with the type of procedure performed. Associated complications were also noted. Results: The mean postoperative mouth opening was 29 mm; analysis revealed that the improvement in mouth opening was not significantly different among the three groups. No recurrence was observed. The most common postop complication was transient paralysis of frontal branch of CN VII. Postop wound infection was observed in two cases. Conclusion: Impeccably performed surgical procedure and vigorous post-surgical physiotherapy forms the cornerstone of a successful outcome. doi:10.1016/j.ijom.2007.08.387
O16.13 Temporomandibular joint ankylosis— a retrospective analysis of 57 cases P. Sharma*, S. Kumar, A. S. Rana, V. Bansal, G. Jain, A. Vikram Department of Oral & Maxillofacial Surgery, G.G.S.M. Subharti Dental College, Meerut, U.P., India Temporomandibular joint (TMJ) ankylosis is still a fairly common disorder in our country due to want of proper medical care following trauma and a lack of awareness. The present series is a retrospective analysis of 57 TMJ ankylosis patients, who reported to our unit between May 1, 2003 and March 31, 2007.The patients were between 6 years and 60 years in age. Different approaches and various treatment modalities were utilized for treatment. Brisement’s force, condylar shaving, high condylectomy, gap arthroplasty and interpositional arthroplasty with a variety of materials was performed to release the ankylosed joint. We have utilized the costochondral graft in a few cases where we wanted growth to occur. An alloplastic condyle was placed in one patient. Distraction osteogenesis was used for reconstruction of facial deformity in two patients of bilateral ankylosis and one patient of unilateral ankylosis with satisfactory results. No case of permanent