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Treatment of TMJ disc displacement without reduction with Mitek Mini anchors: A prospective study
028C - Temporomandibular joint." diagnosis, non-surgical and surgical management O28C - Temporomandibular joint: diagnosis, non-surgical and surgical m a n a g e m e n t
1. TMJ Arthrocentesis and Blunt Sweeping of the Superior Joint Space
Tarro, A. Department of Oral and Maxillofacial Surgery, Boston University School of Graduate Dentistry, Boston, MA This presentation includes the indications, technique, and results of TMJ arthrocentesis and blunt sweeping of the TMJ superior joint space in the oral surgery office. The indications are sudden onset, closed lock TMJ cases with minimal TMJ history and postoperative adhesions after arthroscopic or open TMJ surgery. The technique used will be presented by sequential slides of an actual case. The results of 84 cases with postoperative follow-up ranging from approximately one year to over six and one half years will be discussed. The conclusion is that sudden-onset, closed lock TMJ cases should be treated with minimally invasive TMJ arthrocentesis and, if necessary, blunt sweeping of the TMJ superior joint space soon after a very brief course of nonsurgical treatment. Closed lock TMJ cases, in the opinion of this surgeon, should not be subj6cted to long term nonsurgical treatment.
Results 12 patients with A D D W O R were studied. 9 were female and 3 male. Ages ranged between 19 and 66 years (median: 35.7-+ 5). Preoperative subjective joint pain showed a median of 11.4-+1.8 points. A progressive diminution in the joint pain was observed with a median of 3.2-+2.1, 12 months after surgery. Preoperative M M O was 29.1-+2.5 rams, and statistically significant improvement in M M O was noted one year after surgery: 35.7-+3.2 mms. Crepitation was noted in 10 joints before surgery, 8 of the joints continued with this sign after the surgical procedure, in 2 joints a reciprocal click appeared. M R I obtained 6 months after surgery showed a normal positioned disc in 10 joints, in 2 joints an anteriorly displaced disc with reduction was noted.
Conclusions Normalization of the position of the disc by M R I with good clinical outcomes have been obtained using this surgical procedure to treat patients with ADDWOR.
3. Correction of Deformities Secondary to TMJ Ankylosis
Dabir, A., Kulkarni, D., Vanannala, J. S.D.M. College of Dentai Sciences and Hospital, Dharwad, India
1) 2. Treatment of TMJ Disc Displacement without Reduction with Mitek Mini Anchors: A Prospective Study
Fernandez-Sanroman, J., Sandovai, J., Goizveta, C, Buscena, C
2&3) 4) 5)
Department of Oral and Maxillofacial Surgery, Povisa Medical Center, Vigo, Spain
97
Correction of facial asymmetry secondary to ankylosis of TMJ. 50 patients treated by osteoarthrotomy costochondral graft, mandibular and maxillary osteotomy. Gross improvement in facial aesthetics and masticatory function and satisfactory opening of mouth. Depending on (1) duration of ankylosis, (2) age of patient, severity of facial deformity varies and need various graft and osteotomies.
Aims Anterior disc displacement without reduction (ADDWOR) have been treated with different surgical and nonsurgical techniques. Disc reposition with fixation using Mitek | Mini anchors could be a new surgical approach to this TMJ disorder. We present our preliminary results using this new surgical method.
4. Primary Treatment for TMJ Osteoarthritis: A Combination Therapy of Arthrocentesis, Range of Motion Exercises and NSAID
Method
1The First Department of oral and Maxillofacial Surgery, 2The Second Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University
Between January, 1996 and December, 1997, 12 patients clin~ically and with M R I diagnosed of having A D D W O R were treated in our department. After unsuccessful conservative treatments they underwent arthrotomy with disc reposition and fixation using a Mitek | Mini anchor. Patients were studied preoperatively, 1, 3, 6, 9, 12, 15, I8, 21 and 24 months after surgery with subjective analogue scales for subjective pain (1-15), and measures of maximal mouth opening (MMO), lateral mandibular movement (LM), protrusive mandibular movement (PM) and presence of sounds over the affected TMJ. Cine-MRI in the saggital plane and co' ronal images of the TMJ were obtained before and 6 months after surgery.
Kurita, K, 1, lshida, El, Ogi, N.z, Maki, L z, Kato, L z, Yuasa, H. 2
Purpose The aim of this study was to analyze the effect of primary treatment for TMJ osteoarthritis within 12 weeks after a combination therapy of arthrocentesis and a range of motion exercises under NSAID.
Subjects and methods Fifty patients with TMJ osteoarthritis, who had moderate and severe TMJ dysfunction, were selected from a consecu-
1. TMJ Arthrocentesis and Blunt Sweeping of the Superior Joint Space
Tarro, A. Department of Oral and Maxillofacial Surgery, Boston University School of Graduate Dentistry, Boston, MA This presentation includes the indications, technique, and results of TMJ arthrocentesis and blunt sweeping of the TMJ superior joint space in the oral surgery office. The indications are sudden onset, closed lock TMJ cases with minimal TMJ history and postoperative adhesions after arthroscopic or open TMJ surgery. The technique used will be presented by sequential slides of an actual case. The results of 84 cases with postoperative follow-up ranging from approximately one year to over six and one half years will be discussed. The conclusion is that sudden-onset, closed lock TMJ cases should be treated with minimally invasive TMJ arthrocentesis and, if necessary, blunt sweeping of the TMJ superior joint space soon after a very brief course of nonsurgical treatment. Closed lock TMJ cases, in the opinion of this surgeon, should not be subj6cted to long term nonsurgical treatment.
Results 12 patients with A D D W O R were studied. 9 were female and 3 male. Ages ranged between 19 and 66 years (median: 35.7-+ 5). Preoperative subjective joint pain showed a median of 11.4-+1.8 points. A progressive diminution in the joint pain was observed with a median of 3.2-+2.1, 12 months after surgery. Preoperative M M O was 29.1-+2.5 rams, and statistically significant improvement in M M O was noted one year after surgery: 35.7-+3.2 mms. Crepitation was noted in 10 joints before surgery, 8 of the joints continued with this sign after the surgical procedure, in 2 joints a reciprocal click appeared. M R I obtained 6 months after surgery showed a normal positioned disc in 10 joints, in 2 joints an anteriorly displaced disc with reduction was noted.
Conclusions Normalization of the position of the disc by M R I with good clinical outcomes have been obtained using this surgical procedure to treat patients with ADDWOR.
3. Correction of Deformities Secondary to TMJ Ankylosis
Dabir, A., Kulkarni, D., Vanannala, J. S.D.M. College of Dentai Sciences and Hospital, Dharwad, India
1) 2. Treatment of TMJ Disc Displacement without Reduction with Mitek Mini Anchors: A Prospective Study
Fernandez-Sanroman, J., Sandovai, J., Goizveta, C, Buscena, C
2&3) 4) 5)
Department of Oral and Maxillofacial Surgery, Povisa Medical Center, Vigo, Spain
97
Correction of facial asymmetry secondary to ankylosis of TMJ. 50 patients treated by osteoarthrotomy costochondral graft, mandibular and maxillary osteotomy. Gross improvement in facial aesthetics and masticatory function and satisfactory opening of mouth. Depending on (1) duration of ankylosis, (2) age of patient, severity of facial deformity varies and need various graft and osteotomies.
Aims Anterior disc displacement without reduction (ADDWOR) have been treated with different surgical and nonsurgical techniques. Disc reposition with fixation using Mitek | Mini anchors could be a new surgical approach to this TMJ disorder. We present our preliminary results using this new surgical method.
4. Primary Treatment for TMJ Osteoarthritis: A Combination Therapy of Arthrocentesis, Range of Motion Exercises and NSAID
Method
1The First Department of oral and Maxillofacial Surgery, 2The Second Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University
Between January, 1996 and December, 1997, 12 patients clin~ically and with M R I diagnosed of having A D D W O R were treated in our department. After unsuccessful conservative treatments they underwent arthrotomy with disc reposition and fixation using a Mitek | Mini anchor. Patients were studied preoperatively, 1, 3, 6, 9, 12, 15, I8, 21 and 24 months after surgery with subjective analogue scales for subjective pain (1-15), and measures of maximal mouth opening (MMO), lateral mandibular movement (LM), protrusive mandibular movement (PM) and presence of sounds over the affected TMJ. Cine-MRI in the saggital plane and co' ronal images of the TMJ were obtained before and 6 months after surgery.
Kurita, K, 1, lshida, El, Ogi, N.z, Maki, L z, Kato, L z, Yuasa, H. 2
Purpose The aim of this study was to analyze the effect of primary treatment for TMJ osteoarthritis within 12 weeks after a combination therapy of arthrocentesis and a range of motion exercises under NSAID.
Subjects and methods Fifty patients with TMJ osteoarthritis, who had moderate and severe TMJ dysfunction, were selected from a consecu-