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Comparison between buccal fat pad and temporomyofascial flap as an interpositional graft material after gap arthroplasty in temporomandibular joint ankylosis cases — a clinical study
237 The aetiology of the ankylose of temporomandibular joint can vary, but most due to the fracture on condylar head. Besides trauma or infection can also be the cause of the ankylose. The treatment of osseous ankylosis is surgery. The procedure of condylectomy and gap arthroplasty is a treatment choice. The case is of a 17-year-old girl who presented to our clinic with the main complaint of mouth opening restriction since two years. The procedure of condylectomy and gap arthroplasty was performed, followed by mouth opening training treatment. The result of normal mouth opening and normal mouth and jaw function was achieved. http://dx.doi.org/10.1016/j.ijom.2017.02.799 The effect of Herbst treatment on amount and direction changes of temporomandibular joint growth: a short-term investigation of cone-beam computed tomography M.K. Sah ∗ , K. Fei-wu, Z. Gang, W. You-chao Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Tongji University, Shanghai, China Objective: To evaluate the amount and direction of temporomandibular joint (TMJ) growth changes with a Class II malocclusion treated with the Herbst appliance via cone-beam computed tomography (CBCT). Methods: Twelve Class II malocclusions were treated with the Herbst appliance. CBCT images obtained one week before treatment (T1), three months during treatment (T2), six months during treatment (T3) and after treatment (T4) were analysed. Results: (1) Signs of ‘double contour’ were observed during T2 or T3 in all objects. Condylar remodelling was analysed: the maximum amount was 2.26 mm, the minimum was 0.80 mm and the mean was 1.77 mm. (2) During the treatment, the growth of condyle was active and the region of remodelling was located at the posterosuperior area of condyle. The condyle was stimulated to remodel toward posterosuperior. (3) The relationship between condyle and glenoid fossa did not change significantly before and after treatment. (4) The remodelling pattern of glenoid fossa was similar with condylar, but the amount of the remodelling of glenoid fossa was less than that of condylar. The anterior incline of postglenoid tubercle was stimulated to remodel toward anteroinferior. Conclusions: Herbst appliance can not only stimulate the posterosuperior border of condyle to remodel toward posterosuperior, but also have effect on glenoid fossa; it can stimulate the anterior incline of postglenoid tubercle to remodel toward anteroinferior; CBCT evaluates the effect of the Herbst appliance intuitively and accurately which has a significant value in the study related to TMJ remodelling. http://dx.doi.org/10.1016/j.ijom.2017.02.800
Comparison between buccal fat pad and temporomyofascial flap as an interpositional graft material after gap arthroplasty in temporomandibular joint ankylosis cases — a clinical study P. Sawadkar ∗ , Y. Kini, G. Venkateshwar, M. Padhye, M. Jain, N. Borkhade, S. Takalkar D. Y. Patil University, School of Dentistry, Navi Mumbai, India Background: Although the buccal fat pad (BFP) and temporomyofascial flap (TMFF) have been used as an interpositional graft materials in temporomandibular joint (TMJ) ankylosis, the longterm fate of both is not known. This study assesses the efficacy of both the interpositional grafts post gap arthroplasty in TMJ ankylosis. Objective: To procure an easy to harvest graft with longevity and low relapse rate in TMJ ankylosis patients. Objectives: (1) To compare the ease of harvesting graft during gap arthroplasty procedure and behaviour of the graft during intraoperative, postoperative and follow up period. (2) To compare complications if any; during and post-placement of the graft and also the efficacy to prevent reankylosis. Methods: 20 subjects with unilateral bony ankylosis of TMJ in the 10–20-years age group over a period of five years were included in the study. After routine preoperative evaluation, the surgical treatment included gap arthroplasty along with interposition of BFP and TMFF in 10 patients each, respectively. Other parameters evaluated were mouth opening, facial weakness, reankylosis and any other complications. Findings: Intraoperative surgical ease of handling and time taken was noted and postoperatively all the patients were analysed for functional morbidity, relapse rate over a follow up period of two to five years. Conclusion: Every interpositional graft materials have their pros and cons. Priority should be given to that graft which is simpler, less technique sensitive, less invasive, involves less risk of complications and reach their goals within the shortest time frame. http://dx.doi.org/10.1016/j.ijom.2017.02.801 High accurate positioning after implantation of the patient specific Groningen temporomandibular joint prosthesis: a cadaver studies for assessment of accuracy F.K.L. Spijkervet ∗ , B. Merema, J. Kraeima Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Background: For patients with severe temporomandibular joint (TMJ) dysfunction surgical treatment with a total joint prosthesis could be indicated. The Groningen-TMJ prosthesis was developed as a stock prosthesis and applied successfully in multiple cases.1 This prosthesis included an original design with a mathematically determined lower pivot point, accounting for both rotational and translational movement of the joint. Objectives: Customisation of medical implants, based on threedimensional planning, leads to improved positioning accuracy and predictability of outcome. This study aims to develop a validated custom TMJ prosthesis, including fully guided surgical implantation, based on the Groningen principles.
Comparison between buccal fat pad and temporomyofascial flap as an interpositional graft material after gap arthroplasty in temporomandibular joint ankylosis cases — a clinical study P. Sawadkar ∗ , Y. Kini, G. Venkateshwar, M. Padhye, M. Jain, N. Borkhade, S. Takalkar D. Y. Patil University, School of Dentistry, Navi Mumbai, India Background: Although the buccal fat pad (BFP) and temporomyofascial flap (TMFF) have been used as an interpositional graft materials in temporomandibular joint (TMJ) ankylosis, the longterm fate of both is not known. This study assesses the efficacy of both the interpositional grafts post gap arthroplasty in TMJ ankylosis. Objective: To procure an easy to harvest graft with longevity and low relapse rate in TMJ ankylosis patients. Objectives: (1) To compare the ease of harvesting graft during gap arthroplasty procedure and behaviour of the graft during intraoperative, postoperative and follow up period. (2) To compare complications if any; during and post-placement of the graft and also the efficacy to prevent reankylosis. Methods: 20 subjects with unilateral bony ankylosis of TMJ in the 10–20-years age group over a period of five years were included in the study. After routine preoperative evaluation, the surgical treatment included gap arthroplasty along with interposition of BFP and TMFF in 10 patients each, respectively. Other parameters evaluated were mouth opening, facial weakness, reankylosis and any other complications. Findings: Intraoperative surgical ease of handling and time taken was noted and postoperatively all the patients were analysed for functional morbidity, relapse rate over a follow up period of two to five years. Conclusion: Every interpositional graft materials have their pros and cons. Priority should be given to that graft which is simpler, less technique sensitive, less invasive, involves less risk of complications and reach their goals within the shortest time frame. http://dx.doi.org/10.1016/j.ijom.2017.02.801 High accurate positioning after implantation of the patient specific Groningen temporomandibular joint prosthesis: a cadaver studies for assessment of accuracy F.K.L. Spijkervet ∗ , B. Merema, J. Kraeima Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands Background: For patients with severe temporomandibular joint (TMJ) dysfunction surgical treatment with a total joint prosthesis could be indicated. The Groningen-TMJ prosthesis was developed as a stock prosthesis and applied successfully in multiple cases.1 This prosthesis included an original design with a mathematically determined lower pivot point, accounting for both rotational and translational movement of the joint. Objectives: Customisation of medical implants, based on threedimensional planning, leads to improved positioning accuracy and predictability of outcome. This study aims to develop a validated custom TMJ prosthesis, including fully guided surgical implantation, based on the Groningen principles.