scholarly journals Use of vascularised cartilage as an additional interposition in temporomandibular ankylosis surgery: Rationale, advantages and potential benefits

2008 ◽  
Vol 41 (02) ◽  
pp. 110-115
Author(s):  
Mukund Jagannathan ◽  
Maksud Devale ◽  
Prashantha Kesari ◽  
Siddharth Karanth
Keyword(s):  
Temporomandibular Joint ◽  
Articular Surface ◽  
Superficial Temporal Artery ◽  
Mouth Opening ◽  
Temporal Artery ◽  
Long Term Results ◽  
Success Rates ◽  
Tmj Ankylosis ◽  
Potential Applicability ◽  
Bony Segment

ABSTRACT Context: Surgery for the release of temporomandibular joint (TMJ) ankylosis is a commonly performed procedure. Various interposition materials have been tried with varying success rates. However, none of these procedures attempt to recreate the architecture of the joint as the glenoid surface is usually left raw. Aims: We aimed to use a vascularised cartilage flap and to line the raw surface of the bone to recreate the articular surface of the joint. Settings and Design: There is a rich blood supply in the region of the helical root, based on branches from the Superficial Temporal Artery (STA), which enables the harvest of vascularised cartilage from the helical root for use in the temporomandibular joint. Materials and Methods: Two cases, one adult and the other a child, of unilateral ankylosis were operated upon using this additional technique. The adult patient had a bony segment excised along with a vascularised cartilage flap for lining the glenoid. The child was managed with an interposition graft of costochondral cartilage following the release of the ankylosis, in addition to the vascularised cartilage flap for lining the glenoid. Results: The postoperative mouth opening was good in both the cases with significant reduction in pain. However, the long-term results of this procedure are yet to be ascertained. Conclusions: The vascularised cartilage flap as an additional interposition material in temporomandibular joint surgery enables early and painless mouth-opening with good short-term results. The potential applicability of this flap in various pathologies of the temporomandibular joint is enormous.

scholarly journals Application of the rapid prototyping technique to design a customized temporomandibular joint used to treat temporomandibular ankylosis

2009 ◽  
Vol 42 (01) ◽  
pp. 085-093
Author(s):  
Suresh M. Chaware ◽  
Vaibhav Bagaria ◽  
Abhay Kuthe
Keyword(s):  
Rapid Prototyping ◽  
Temporomandibular Joint ◽  
Three Dimensional ◽  
Mouth Opening ◽  
Clinical Results ◽  
Postoperative Recovery ◽  
Normal Diet ◽  
Success Rates ◽  
Tmj Ankylosis ◽  
Custom Made

ABSTRACTAnthropometric variations in humans make it difficult to replace a temporomandibular joint (TMJ), successfully using a standard “one-size-fits-all” prosthesis. The case report presents a unique concept of total TMJ replacement with customized and modified TMJ prosthesis, which is cost-effective and provides the best fit for the patient. The process involved in designing and modifications over the existing prosthesis are also described. A 12-year- old female who presented for treatment of left unilateral TMJ ankylosis underwent the surgery for total TMJ replacement. A three-dimensional computed tomography (CT) scan suggested features of bony ankylosis of left TMJ. CT images were converted to a sterolithographic model using CAD software and a rapid prototyping machine. A process of rapid manufacturing was then used to manufacture the customized prosthesis. Postoperative recovery was uneventful, with an improvement in mouth opening of 3.5 cm and painless jaw movements. Three years postsurgery, the patient is pain-free, has a mouth opening of about 4.0 cm and enjoys a normal diet. The postoperative radiographs concur with the excellent clinical results. The use of CAD/CAM technique to design the custom-made prosthesis, using orthopaedically proven structural materials, significantly improves the predictability and success rates of TMJ replacement surgery.

scholarly journals Temporomandibular Joint (TMJ) Ankylosis Resection to Total Joint replacement – 30 Years Journey

2021 ◽  
Vol 33 (2) ◽  
Keyword(s):  
Temporomandibular Joint ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Articular Surface ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Patient Specific ◽  
Mandibular Fractures ◽  
Tmj Ankylosis ◽  
Condyle Fracture

Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disc–condyle complex to the temporal articular surface that confines the mandibular drive, including the fibrous adhesions/ bony fusion between condyle, disc, glenoid fossa, and eminence. It is a severe and incapacitating ailment that can cause mastication, digestion, speech, appearance, and hygiene concerns. This is an unusual case of a 42-year-old adult patient, who suffered from bilateral recurrent TMJ ankylosis and reported following trauma to the face. The patient had a history of mandibular condyle fracture at ten years of age. Excision of existing ankylotic mass followed by reconstruction with patient-specific total joint replacement (TJR) was carried out. Postoperative physiotherapy exercises in the presented case improved patient’s mouth opening, and mandibular movement. Patient-specific TJR procedures and postoperative physiotherapy will be helpful in cases with TMJ ankylosis. Keywords: Genioplasty; Mandibular Condyle; Mandibular fractures; Temporomandibular Ankylosis; Temporomandibular Joint

scholarly journals A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

2018 ◽  
Vol 18 (3) ◽  
pp. 379 ◽  
Author(s):  
Issa K. Al-Nuumani ◽  
Abdulaziz Bakathir ◽  
Ahmed Al-Hashmi ◽  
Mohammed Al-Abri ◽  
Hussein Al-Kindi ◽  
...  
Keyword(s):  
Case Report ◽  
Temporomandibular Joint ◽  
Obstructive Sleep Apnoea ◽  
Mouth Opening ◽  
Sleep Apnoea ◽  
Temporomandibular Joint Disorders ◽  
University Hospital ◽  
Tmj Ankylosis ◽  
Obstructive Sleep ◽  
Mandibular Retrognathia

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.Keywords: Temporomandibular Joint Disorders; Temporomandibular Ankylosis; Retrognathia; Obstructive Sleep Apnea; Case Report; Oman.

Superficial Temporal Artery to Proximal Middle Cerebral Artery Anastomosis: Clinical and Angiographic Long Term Results

Neurosurgery ◽  
1986 ◽  
Vol 19 (6) ◽  
pp. 992-997 ◽  
Author(s):  
Massimo Collice ◽  
Orazio Arena ◽  
Romero A. Fontana
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Good Alternative ◽  
Neurological Complications ◽  
Long Term Results ◽  
Cortical Surface ◽  
First Choice

Abstract Anastomosis of the superficial temporal artery (STA) with a proximal segment of the middle cerebral artery (MCA) has been proposed as a new cerebral revascularization technique alternative to the conventional bypass on the cortical surface. We introduced this procedure in our surgical practice in 1982 for patients with internal carotid artery (ICA) aneurysms not suitable for direct repair in whom occlusion of the ICA is considered necessary. One patient died because a conventional STA-MCA bypass did not prevent a major stroke caused by a therapeutic ICA occlusion. We are reporting our surgical technique and the immediate and long term clinical and angiographic results in five cases operated on during the period June 19, 1982, through January 19, 1983. The early and late patency rates were good. No neurological complications were observed after the bypass procedure or during a 3-year follow-up period. In our opinion, the use of proximal segments of the MCA as recipient arteries for supratentorial revascularization is a good alternative to the use of cortical surface arteries and, in selected cases, could be the first choice technique.

scholarly journals Bilateral asymptomatic fibrous-ankylosis of the temporomandibular joint associated with rheumatoid arthritis: a case report

2012 ◽  
Vol 23 (6) ◽  
pp. 779-782 ◽  
Author(s):  
Carolina Ortigosa Cunha ◽  
Lívia Maria Sales Pinto ◽  
Luana Menezes de Mendonça ◽  
Aline Dantas Diógenes Saldanha ◽  
Ana Cláudia de Castro Ferreira Conti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporomandibular Joint ◽  
Correct Diagnosis ◽  
Mouth Opening ◽  
Limited Range ◽  
Contralateral Side ◽  
Limited Mouth Opening ◽  
Tmj Ankylosis ◽  
Inflammatory Conditions ◽  
Limited Range Of Motion

The American Academy of Orofacial Pain (AAOP) defines ankylosis of the temporomandibular joint (TMJ) as a restriction of movements due to intracapsular fibrous adhesions, fibrous changes in capsular ligaments (fibrous-ankylosis) and osseous mass formation resulting in the fusion of the articular components (osseous-ankylosis). The clinical features of the fibrous-ankylosis are severely limited mouth-opening capacity (limited range of motion during the opening), usually no pain and no joint sounds, marked deflection to the affected side and marked limitation of movement to the contralateral side. A variety of factors may cause TMJ ankylosis, such as trauma, local and systemic inflammatory conditions, neoplasms and TMJ infection. Rheumatoid arthritis (RA) is one of the systemic inflammatory conditions that affect the TMJ and can cause ankylosis. The aim of this study is to present a case of a female patient diagnosed with bilateral asymptomatic fibrous-ankylosis of the TMJ associated with asymptomatic rheumatoid arthritis. This case illustrates the importance of a comprehensive clinical examination and correct diagnosis of an unusual condition causing severe mouth opening limitation.

scholarly journals Gap Arthroplasty of Bilateral Temporomandibular Joint Ankylosis

2014 ◽  
Vol 29 (2) ◽  
pp. 28-31
Author(s):  
Ferdinand Z. Guintu ◽  
Alexander T. Laoag ◽  
Joselito F. David
Keyword(s):  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Tmj Ankylosis ◽  
Temporomandibular Joint Ankylosis ◽  
Gap Arthroplasty ◽  
Long Term Follow Up ◽  
Preauricular Approach ◽  
Temporal Bones ◽  
Joint Ankylosis

Objective: To present a case of bilateral temporomandibular joint ankylosis that was managed successfully through gap arthroplasty. Methods: Design:   Case report Setting:   Tertiary Government Hospital Patient:   One Results: A 25-year-old man presented with inability to open his mouth for 18 years after direct trauma to his chin.  CT scan showed bilateral bony fusion of condyles to glenoid fossae, hypertrophic sclerosis and fusion of the condylar heads to the temporal bones. He underwent bilateral gap arthroplasty via preauricular approach with creation of a 15 mm space on the mandibular fossa. As of latest follow up, the patient maintained an inter-alveolar distance of 30 mm for 5 months postoperatively, through continuous aggressive mouth opening exercises. Conclusion:      Gap arthroplasty may be an efficient procedure for temporomandibular joint ankylosis in achieving satisfactory post-operative inter-alveolar opening and articular function. Early and meticulous rehabilitation is required to prevent relapse. Long-term follow up is recommended to document possible recurrence.   Keywords: temporomandibular joint ankylosis, gap arthroplasty, TMJ ankylosis, ankylosis

scholarly journals Tissue Engineered Vascularized Patient-Specific Temporomandibular Joint Reconstruction in a Yucatan Pig Model

2020 ◽  
Author(s):  
Shelly Abramowicz ◽  
Sarah Jo Crotts ◽  
Scott J. Hollister ◽  
Steve Goudy
Keyword(s):  
Temporomandibular Joint ◽  
Porcine Model ◽  
Superficial Temporal Artery ◽  
Mandibular Condyle ◽  
Temporal Artery ◽  
Patient Specific ◽  
Temporalis Muscle ◽  
Control Side ◽  
Titanium Screws ◽  
3D Printed

ABSTRACTPurposePediatric temporomandibular joint (TMJ) reconstruction occurs as a result of acquired, developmental, and/or congenital conditions. Current pediatric reconstruction options are limited. The aim of this project was to develop a proof of principle porcine model for a load bearing, customized 3-dimensional (3D) printed and BMP2-coated scaffold implanted in a pedicled (temporal) flap as a regenerative approach to pediatric TMJ mandibular condyle reconstruction.Materials and MethodsScaffolds were custom designed and 3D printed based on porcine computed tomography and absorbed with BMP2. Two operations occured: (1) implantation of scaffold in temporalis muscle to establish vascularity, and six weeks later, (2) unilateral condylectomy and rotation of the vascularized scaffold (with preservation of superficial temporal artery) onto mandibular ramus defect and secured with titanium screws. At 6 months post-implantation, the pigs were sacrified. The experimental side (muscle-scaffold) and the control side (unoperated condyle) were individually harvested at 6 months and evaluated by clinical, mechanical, radiographic, and qualitative/histologic methods.ResultsScaffolds maintained physical properties similar in appearance to unoperated condyles. The vascularized scaffolds had bone formation at edges and adjacent to scaffold-bone interface. New bone was visible in scaffold. Condyle height on the reconstructed side was 68% and 78% of the control side. Reconstructed condyle stiffness was between 20% and 45% of the control side.ConclusionIn our porcine model, customized 3D printed TMJ scaffolds impregnanted with BMP2 and implanted in and pedicled on temporalis muscle has the ability to (1) reconstruct a TMJ defect model, (2) maintain appropriate condylar height and upper airway diameter, and (3) generate new bone, without impacting functional outcomes.

scholarly journals Functional and Aesthetic Outcome Following Simultaneous Temporomandibular Joint Ankylosis Release and Correction of Chin Discrepancy by Lower Border Osteotomy-A Case Report

2021 ◽  
pp. 439-442
Author(s):  
Datarkar AN ◽  
Anukula H ◽  
Walke D ◽  
Deshpande A ◽  
Rai A
Keyword(s):  
Case Report ◽  
Temporomandibular Joint ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Tmj Ankylosis ◽  
Facial Disfigurement ◽  
Quality Life ◽  
Old Adult ◽  
Osteotomy Technique ◽  
History Of

This is a case report of a 19 year old adult female with facial asymmetry secondary to right Temporomandibular Joint (TMJ) ankylosis with a history of previous surgery at the age of 10 years with gap arthroplasty for tmj ankylosis which was unsuccessful and lead to relapse .Because of decreased mouth opening and facial disfigurement patient was not able to have a quality life. She reported to our department where she got operated simultaneously for tmj ankylosis with interpositional arthroplasty using temporalis myofascial flap and novel osteotomy technique for correction of chin asymmetry. After surgery there is a significant improvement in patient both functionally and aesthetically.

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