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Lateral arthroplasty versus conventional arthroplasty in Sawhney's type III temporomandibular joint ankylosis: a comparison
233 Results: In all the subjects the procedure was uneventful and there was no evidence of recurrence. There was a clinically significant improvement in mouth opening, lateral movements, clicking and deviation with P < 0.001 and also there was a remarkable reduction in pain over a period of six months. Conclusion: From the above results and statistical analysis it is possible to conclude single puncture arthrocentesis to be very effective and less invasive procedure with minimal complications. Future studies with larger sample size and longer duration of follow-up will test the true efficacy of this technique. http://dx.doi.org/10.1016/j.ijom.2017.02.786 Lateral arthroplasty versus conventional arthroplasty in Sawhney’s type III temporomandibular joint ankylosis: a comparison S. Mohammad Department of Oral and Maxillofacial Surgery, King George’s Medical University, Lucknow, UP, India
Postoperative complication of mandibular condyle fracture associated with osteosynthesis material treated with total temporomandibular joint reconstruction: case report J.N. Nogueira Neto ∗ , J.F.C. Dantas, P.S.F. Campos Federal University of Bahia, Brazil Total condylar resorption and failure of bone synthesis material as postoperative complications of condyle fracture are condyle fracture complications seldom related in the literature. When these occur, they may make temporomandibular joint function unfeasible, with indication for reconstruction of this joint, which can be achieved by means of alloplastic prosthesis. The aim of this article was to report a rare case of impaction of osteosynthesis material in the region at the base of the skull, with the result of complication of the mandibular condyle fracture treated with rigid internal fixation that evolved with condylar resorption, in which alloplastic temporomandibular joint reconstruction was performed in a single surgical session. http://dx.doi.org/10.1016/j.ijom.2017.02.788
Background: Temporomandibular joint (TMJ) ankylosis is a challenging condition leading to fusion of the mandibular condyle with base of the skull causing distressing conditions which leads to facial disfigurement, compromise airway, aesthetics, function and psychological stress. Sawhney’s type III ankylosis involves an improperly treated or displaced condyle process fracture. A clear bridge of bone is present between the ramus and zygomatic arch and after the bony bridge is excised the upper articular surface and the articular on deeper surface are intact. A condyle of reduced size and slightly medial to normal anatomical exists and is functional. Objectives: To compare the effectiveness between lateral arthroplasty and conventional arthroplasty in Sawhney’s type III TMJ ankylosis. Methods: A total of 20 patients were included in this study. Lateral arthroplasty was done in 10 patients preserving the medial condyle. Conventional arthroplasty was done in 10 patients. Finding and Conclusion: Patients were followed up to maximum of six months and following conclusions were drawn. The maximum intercisional mouth opening was slightly better in control group (42 + 3 mm) as compared to lateral arthroplasty group. Protrusive and lateral movement was better in lateral arthroplasty group. In lateral arthroplasty group deviation in mouth opening was almost nil in the cases as the vertical relation of mandible was maintained. The present follow up of lateral arthroplasty technique is a superior technique as compared to conventional arthroplasty technique based on the clinical outcomes in Sawhney’s type III ankylosis and lateral arthroplasty also has the advantage of being a conservative procedure. http://dx.doi.org/10.1016/j.ijom.2017.02.787
Demographic features in unilateral condylar hyperplasia: an overview of more than 300 asymmetric cases and presentation of an algorithm J. Nolte ∗ , L. Karssemakers, R. Schreurs, D. Tuinzing, A. Becking Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands Background: Unilateral condylar hyperplasia (UCH) is an acquired mandibular deformity, which can influence facial symmetry due to its progressive nature. Definition, classification and treatment are subject to discussion. Objectives: The study aim is to evaluate the clinical characteristics, demographic features, classification and follow-up in a large cohort of suspected UCH patients. From this evaluation, a uniform diagnosis and treatment algorithm is established. Methods: The charts of asymmetric patients with suspected UCH from 3 Maxillofacial Centers (Academic Medical Center, VU Medical Center and Spaarne Gasthuis) from 1994 to 2014 were retrospectively evaluated. Patients were referred by orthodontists, dentists, general practitioners or maxillofacial surgeons. Demographic features, bone scan outcomes, laterality, diagnosis (elongation/hyperplasia/hybrid) and follow-up were noted. Secondarily, all patients were retrospectively diagnosed by one surgeon (JN), using available documentation. Missing data and follow-up were additionally retrieved from orthodontic offices. Findings: 394 asymmetric patients were evaluated. The mean age at presentation was 20.7 years, with a male/female ratio of 176:218. A condylectomy was performed in 175 patients; 106 of these had a positive bonescan. In 114 patients, orthognathic surgery was performed. In only 70% of the cases, secondary screening was in agreement with the initial diagnosis and laterality. Conclusion: Clinically, it is difficult to objectively classify patients. Uniformity in documentation and measured parameters is obligatory in order to reach evidence-based conclusions and be
Postoperative complication of mandibular condyle fracture associated with osteosynthesis material treated with total temporomandibular joint reconstruction: case report J.N. Nogueira Neto ∗ , J.F.C. Dantas, P.S.F. Campos Federal University of Bahia, Brazil Total condylar resorption and failure of bone synthesis material as postoperative complications of condyle fracture are condyle fracture complications seldom related in the literature. When these occur, they may make temporomandibular joint function unfeasible, with indication for reconstruction of this joint, which can be achieved by means of alloplastic prosthesis. The aim of this article was to report a rare case of impaction of osteosynthesis material in the region at the base of the skull, with the result of complication of the mandibular condyle fracture treated with rigid internal fixation that evolved with condylar resorption, in which alloplastic temporomandibular joint reconstruction was performed in a single surgical session. http://dx.doi.org/10.1016/j.ijom.2017.02.788
Background: Temporomandibular joint (TMJ) ankylosis is a challenging condition leading to fusion of the mandibular condyle with base of the skull causing distressing conditions which leads to facial disfigurement, compromise airway, aesthetics, function and psychological stress. Sawhney’s type III ankylosis involves an improperly treated or displaced condyle process fracture. A clear bridge of bone is present between the ramus and zygomatic arch and after the bony bridge is excised the upper articular surface and the articular on deeper surface are intact. A condyle of reduced size and slightly medial to normal anatomical exists and is functional. Objectives: To compare the effectiveness between lateral arthroplasty and conventional arthroplasty in Sawhney’s type III TMJ ankylosis. Methods: A total of 20 patients were included in this study. Lateral arthroplasty was done in 10 patients preserving the medial condyle. Conventional arthroplasty was done in 10 patients. Finding and Conclusion: Patients were followed up to maximum of six months and following conclusions were drawn. The maximum intercisional mouth opening was slightly better in control group (42 + 3 mm) as compared to lateral arthroplasty group. Protrusive and lateral movement was better in lateral arthroplasty group. In lateral arthroplasty group deviation in mouth opening was almost nil in the cases as the vertical relation of mandible was maintained. The present follow up of lateral arthroplasty technique is a superior technique as compared to conventional arthroplasty technique based on the clinical outcomes in Sawhney’s type III ankylosis and lateral arthroplasty also has the advantage of being a conservative procedure. http://dx.doi.org/10.1016/j.ijom.2017.02.787
Demographic features in unilateral condylar hyperplasia: an overview of more than 300 asymmetric cases and presentation of an algorithm J. Nolte ∗ , L. Karssemakers, R. Schreurs, D. Tuinzing, A. Becking Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands Background: Unilateral condylar hyperplasia (UCH) is an acquired mandibular deformity, which can influence facial symmetry due to its progressive nature. Definition, classification and treatment are subject to discussion. Objectives: The study aim is to evaluate the clinical characteristics, demographic features, classification and follow-up in a large cohort of suspected UCH patients. From this evaluation, a uniform diagnosis and treatment algorithm is established. Methods: The charts of asymmetric patients with suspected UCH from 3 Maxillofacial Centers (Academic Medical Center, VU Medical Center and Spaarne Gasthuis) from 1994 to 2014 were retrospectively evaluated. Patients were referred by orthodontists, dentists, general practitioners or maxillofacial surgeons. Demographic features, bone scan outcomes, laterality, diagnosis (elongation/hyperplasia/hybrid) and follow-up were noted. Secondarily, all patients were retrospectively diagnosed by one surgeon (JN), using available documentation. Missing data and follow-up were additionally retrieved from orthodontic offices. Findings: 394 asymmetric patients were evaluated. The mean age at presentation was 20.7 years, with a male/female ratio of 176:218. A condylectomy was performed in 175 patients; 106 of these had a positive bonescan. In 114 patients, orthognathic surgery was performed. In only 70% of the cases, secondary screening was in agreement with the initial diagnosis and laterality. Conclusion: Clinically, it is difficult to objectively classify patients. Uniformity in documentation and measured parameters is obligatory in order to reach evidence-based conclusions and be