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Annals of the Royal College of Surgeons... Jan 1999This is a review of 204 patients with temporomandibular joint (TMJ) ankylosis treated according to a definitive protocol in the Cranio-Maxillo-Facial Department of the...
This is a review of 204 patients with temporomandibular joint (TMJ) ankylosis treated according to a definitive protocol in the Cranio-Maxillo-Facial Department of the Alexandria University Hospital during the period 1990-1996 with a follow-up varying from 1.5 to 7 years. A history of trauma was confirmed in 98% of cases. Patients were grouped into: (1) Those with ankylosis not associated with facial deformities. The management involves release of the ankylosed joint(s) and reconstruction of the condyle ramus unit(s) (CRUs) using costochondral graft(s) (CCGs). (2) Those with mandibular ankylosis complicated by facial bone deformities, either asymmetric or bird face. The treatment consists of release of the ankylosis, reconstruction of the CRUs, and correction of jaw deformities--all performed simultaneously. Respiratory embarrassment was an important presenting symptom in the second group, all of whom complained of night snoring, eight of whom had obstructive sleep apnoea (OSA). In this latter group, respiratory obstruction improved dramatically after surgical intervention. The degree of mouth opening, monitored as the interincisal distance (IID) improved from a range of 0-12 mm to over 30 mm in 62% of patients and to 20-30 mm in 29% of patients. However, reankylosis was still around 8% and was attributed to lack of patient compliance in 75% and to iatrogenic factors in 25% of patients. CCGs resorption, whether partial or complete, occurred in 27% of patients, resulting in retarded growth, relapse of deformities and night snoring.
Topics: Adolescent; Adult; Ankylosis; Bone Transplantation; Cartilage; Child; Child, Preschool; Facial Asymmetry; Facies; Female; Follow-Up Studies; Humans; Male; Postoperative Care; Sleep Apnea Syndromes; Temporomandibular Joint; Treatment Outcome
PubMed: 10325678
DOI: No ID Found -
Journal of Dentistry For Children... 2009Ankylosis of the temporomandibular joint (TMJ) is a clinical manifestation with multiple etiologies that interferes with the growth of the affected condyle, owing to its...
Ankylosis of the temporomandibular joint (TMJ) is a clinical manifestation with multiple etiologies that interferes with the growth of the affected condyle, owing to its fusion with both the glenoid cavity and the skull base with a limitation of mandibular movement, occlusion or forced semi-occlusion, speech and feeding difficulties, and facial asymmetry. Diagnosis and treatment of these oral manifestations are complex, involving several health practitioners such physicians, dental surgeons, physiotherapists, and psychologists. The purpose of this paper is to report a case of a 3-year-old female who presented with limited mouth opening and facial deformity due to birth trauma, which resulted in right TMJ ankylosis and consequently affected the child's growth and 'social' life.
Topics: Ankylosis; Birth Injuries; Child, Preschool; Female; Humans; Temporomandibular Joint Disorders
PubMed: 19341578
DOI: No ID Found -
The Journal of Small Animal Practice Sep 2007This report evaluates the suitability of using an external fixator as the sole means of correcting tarsometatarsal luxations. Four dogs were included in this report....
This report evaluates the suitability of using an external fixator as the sole means of correcting tarsometatarsal luxations. Four dogs were included in this report. Each dog weighed more than 20 kg and had sustained a tarsometatarsal luxation with plantar, medial or lateral instability. The luxations were immobilised with an external fixator for between 12 and 17 weeks. The surgery did not involve soft tissue dissection, debridement of articular cartilage or a cancellous bone graft and no external coaptation was used postoperatively. The result of this treatment was to ankylose the tarsometatarsal luxation and allow the dogs to return to normal function.
Topics: Animals; Ankylosis; Dogs; External Fixators; Female; Joint Dislocations; Male; Metatarsus; Tarsus, Animal; Treatment Outcome
PubMed: 17559525
DOI: 10.1111/j.1748-5827.2006.00299.x -
Revue de Stomatologie Et de Chirurgie... Apr 2004
Review
Topics: Ankylosis; Diagnosis, Differential; Humans; Oral Surgical Procedures; Plastic Surgery Procedures; Temporomandibular Joint Disorders
PubMed: 15211221
DOI: 10.1016/s0035-1768(04)72289-5 -
International Surgery 2010Elbow ankylosis and its management remain a challenge in the developing countries like Nigeria because of many factors, including the absence of elbow replacement... (Review)
Review
Elbow ankylosis and its management remain a challenge in the developing countries like Nigeria because of many factors, including the absence of elbow replacement surgery. Current operative management, which is interposition arthroplasty with fascia lata or arthrodesis in a more functional position, is commonly complicated with donor site morbidity and restricted functionality, respectively. We report the use of the regional radial recurrent fasciocutaneous flap of the arm as an interposition material for an ankylosed elbow after excision of the bone block, with no donor site morbidity and improved range of elbow motion. At 4 years postoperatively, patient is very satisfied with functionality. Additionally, this method of managing elbow ankylosis uses a vascularized and durable flap, is cheap, and has less operation time, and thus is highly recommended.
Topics: Adult; Ankylosis; Arm; Arthroplasty; Elbow Joint; Humans; Iatrogenic Disease; Male; Nigeria; Radial Artery; Range of Motion, Articular; Surgical Flaps; Elbow Injuries
PubMed: 21309413
DOI: No ID Found -
Journal of Cranio-maxillo-facial... Mar 2006Restoration of normal function and jaw movement in patients with temporomandibular joint (TMJ) ankylosis is difficult. Various techniques have been defined for the...
INTRODUCTION
Restoration of normal function and jaw movement in patients with temporomandibular joint (TMJ) ankylosis is difficult. Various techniques have been defined for the treatment of the condition.
PATIENTS
This study is based on the pre-, intra- and post-operative evaluation of 78 TMJ operations in 59 patients who were treated for TMJ ankylosis between 1985 and 2002.
METHODS
The patients in this study were evaluated with regard to age, gender, aetiology of ankylosis, ankylosis type/classification, existing facial asymmetry, maximal pre- and post-operative mouth opening, the arthroplasty methods (gap and interpositional arthroplasty) including complications and recurrence of ankylosis.
RESULTS
Falls represented the most widespread aetiological factor (85%), and women constituted the group with the highest incidence of ankylosis (61%). Forty cases were unilateral (68%) and 19 bilateral (32%); 82% (64 joints) were of the bony type. Gap arthroplasty was applied in 34 of the 59 cases (58%) and interpositional arthroplasty in the remaining 25 (42%). Pre- and post-operative mean mouth opening were 3.5+/-1.7 and 30.7+/-3.0mm, respectively. Re-ankylosis was noted in 5%.
CONCLUSION
In addition to radical and sufficient resection of the ankylosed bone, early post-operative exercises, appropriate physiotherapy and close follow-up of the patient play an important role in the prevention of post-operative adhesions and re-ankylosis.
Topics: Adolescent; Adult; Ankylosis; Arthroplasty; Child; Child, Preschool; Face; Female; Humans; Infant; Male; Postoperative Complications; Sex Distribution; Temporomandibular Joint; Treatment Outcome
PubMed: 16423530
DOI: 10.1016/j.jcms.2005.07.008 -
International Journal of Oral and... Nov 2020Temporomandibular joint ankylosis (TMJA) is a complicated condition that affects not only the condyle, but also the maxillofacial complex. Thus, it is often challenging...
Temporomandibular joint ankylosis (TMJA) is a complicated condition that affects not only the condyle, but also the maxillofacial complex. Thus, it is often challenging to find a standardized treatment strategy for TMJA. This study was performed to analyse our experience with 95 TMJA patients over a 4-year period and develop a new classification system ('CDA'). The CDA classification system divides TMJA patients into eight different groups according to the preservability of the condyle (C), severity of the dentofacial bone deformity (D), and skeletal age (A). The 95 patients (129 ankylosed joints) were treated using different strategies based on this CDA classification. Treatment options included preserving or reconstructing the condylar head, surgical correction of jaw deformities, and close follow-up of mandibular growth. After treatment, all 129 ankylosed joints were completely released and the average maximum inter-incisal opening (MIO) increased from 3.6 ± 3.2 mm to 32.8 ± 5.4 mm, with no recurrence of ankylosis found during follow-up. In conclusion, this new CDA classification can effectively guide treatment strategies for TMJA patients. Using particular strategies for patients based on specific CDA classifications could provide optimal management to the benefit of TMJA patients.
Topics: Ankylosis; Arthroplasty; Humans; Mandible; Mandibular Condyle; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 32247547
DOI: 10.1016/j.ijom.2020.02.020 -
Revue de Stomatologie, de Chirurgie... Nov 2016Dislocation of the mandibular condyle into the middle cranial fossa after a trauma is a rare event. The lack of appropriate treatment can lead to ankylosis of the...
INTRODUCTION
Dislocation of the mandibular condyle into the middle cranial fossa after a trauma is a rare event. The lack of appropriate treatment can lead to ankylosis of the temporomandibular joint (TMJ). We report about a case of TMJ ankylosis following intracranial dislocation of the mandibular condyle through the roof of the articular fossa.
CASE REPORT
A 9-year-old patient was referred for a severe limitation of mouth opening that began progressively one year before. A history of chin injury due to an accidental fall was found. Preoperative CT scan showed a TMJ ankylosis on the right side combined with a dislocation of the mandibular condyle into the middle cranial fossa. Treatment consisted in an intracranial resection of the mandibular condyle, partial removal of the ankylosis block and TMJ arthroplasty.
DISCUSSION
Our case is the second case of TMJ ankylosis following intracranial dislocation of the mandibular condyle and treated with arthroplasty alone published in the English literature. There is no consensus regarding the pathophysiology of TMJ ankylosis and regarding the attitude towards the ankylosis block. In our case, no recurrence was noticed after a one-year follow-up. An interdisciplinary approach is needed, including maxillofacial surgeon, neurosurgeon, physiotherapist and orthodontist.
Topics: Accidental Falls; Ankylosis; Child; Cranial Fossa, Middle; Humans; Joint Dislocations; Male; Mandibular Condyle; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 27473929
DOI: 10.1016/j.revsto.2016.06.001 -
Oral Surgery, Oral Medicine, Oral... Sep 2014We aimed to study the pathology underlying traumatic temporomandibular joint ankylosis (TMJA).
OBJECTIVE
We aimed to study the pathology underlying traumatic temporomandibular joint ankylosis (TMJA).
STUDY DESIGN
Specimens from 10 patients with traumatic TMJA were categorized using the Sawhney classification and were decalcified and stained with hematoxylin-eosin, alcian blue/periodic acid-Schiff, alizarin red, and Masson stains. Immunostaining with anti-CD34 antibody was performed. Computed tomography and pathologic findings were compared.
RESULTS
Ankylosed areas consisted of fibrocartilaginous tissues. Bone formation occurred by osteophyte extension from the osteochondral surface toward the mass center. Endochondral ossification and osteophyte proliferation, alone or simultaneously, participated in bony ankylosis. Sequestra in the cartilaginous ankylosis preferentially formed bony bridges. Newly formed capillaries participated in ossification from the bony surface of the bone-cartilage junction; bone formed around the capillaries. Osteoclasts were present at the capillary tips.
CONCLUSIONS
Types II and III were cartilaginous-bony ankylosis, with similar components. Bony traumatic TMJA was formed by osteophyte proliferation and endochondral ossification.
Topics: Adolescent; Adult; Ankylosis; Humans; Immunoenzyme Techniques; Male; Middle Aged; Radiography, Panoramic; Temporomandibular Joint; Temporomandibular Joint Disorders; Tomography, X-Ray Computed
PubMed: 25151587
DOI: 10.1016/j.oooo.2014.05.007 -
Revue de Stomatologie Et de Chirurgie... 1994Ankylosis of the temporomandibular joint has severe consequences due to its effect on eating, speaking, buccal hygiene and growth of the lower third of the face in... (Review)
Review
Ankylosis of the temporomandibular joint has severe consequences due to its effect on eating, speaking, buccal hygiene and growth of the lower third of the face in children. Two therapeutic problems must be addressed: functional capacity (joint mobility) and morphological (correction of the facial deformation). The appropriate surgical techniques are still subject to debate. Each operator has a technique which gives satisfactory results. In our unit, we used two techniques with similar results. Early and prolonged rehabilitation still remains the only guarantee of success.
Topics: Ankylosis; Humans; Joint Prosthesis; Physical Therapy Modalities; Prosthesis Design; Retrospective Studies; Temporomandibular Joint Disorders
PubMed: 8036415
DOI: No ID Found