scholarly journals ANQUILOSE DE ATM EM PACIENTE PEDIÁTRICO: RELATO DE CASO

2019 ◽  
Author(s):  
Rodrigo Figueiredo de Brito Resende
Keyword(s):  
Correct Diagnosis ◽  
Facial Asymmetry ◽  
Radiographic Evaluation ◽  
Autogenous Bone ◽  
Mandibular Growth ◽  
Tmj Ankylosis ◽  
Joint Reconstruction ◽  
Interpositional Arthroplasty ◽  
Mandibular Retrusion ◽  
Costochondral Graft

RESUMO: A anquilose da ATM caracteriza-se pela substituição dos tecidos articulares por tecido ósseo ou fibro-ósseo, gerando uma união entre os componentes ósseos da articulação, tal alteração gera comprometimento da função articular. A anquilose da ATM quando ocorre na infância pode prejudicar o crescimento mandibular, causando posteriormente uma assimetria facial severa entre outros. Sua etiopatogenia é variável, desde traumas até reações a injeções intra-capsulares de medicamentos.O correto diagnóstico só é obtido por meio de avaliação clínica e radiográfica, incluindo tomografia computadorizada e reconstruções em 3D-TC. Há diferentes modalidades cirúrgicas para seu tratamento, artroplastia em GAP, Artroplastia Interposicional utilizando-se da interposição de um material biológico ou não, e a reconstrução conjunta da ATM, com enxertia de osso autógeno ou prótese articular total, todas preconizando ressecção agressiva da massa anômala fibrosa e/ou óssea.O presente trabalho visa relatar cirurgia de remoção de massa anquilótica óssea em ATM  no serviço de CTBMF do HFSE do RJ. Paciente do sexo feminino, 7 anos, melanoderma, AMI de 15mm, acesso Al-Kayat, ressecção de massa anquilótica óssea, coronoidectomia bilateral, revestimento com aba miofascial de temporal, enxerto autógeno costocondral. Paciente evoluiu com AMI de 35mm e acompanhamento de 2 anos. Demonstrando eficácia e previsibilidade do tratamento escolhido, segundo protocolo Kaban.Palavras-chaves: Anquilose de ATM; Enxerto Costocondral; ArtroplastiaInterposicional; Protocolo Kaban                                                                 ABSTRACT: TMJ ankylosis is characterized by the replacement of the joint tissues by bone or fibro-osseous tissue, generating a union between the bone components of the joint, such alteration causes compromised joint function. TMJ ankylosis when it occurs in childhood may impair mandibular growth, causing severe facial asymmetry and mandibular retrusion, difficulty in phonation, among others. Its etiopathogenesis varies from traumas to reactions to intra-capsular injections of medications. Correct diagnosis is only obtained through clinical and radiographic evaluation, including computed tomography and 3DCT reconstructions. There are different surgical modalities for its treatment, GAP arthroplasty, Interpositional arthroplasty using the interposition of a biological material or not, and the joint reconstruction of TMJ, with autogenous bone excision or total joint prosthesis, all of which advocate aggressive resection of the anomalous mass fibrosis and / or bone. The present study aims to report bone ankylosis mass removal surgery in TMJ in the CTBMF service of the HFSE of RJ. Female patient, 7 years old, melanoderma, 15 mm AMI, general anesthesia, Al-Kayat access, bone ankylotic mass resection, bilateral coronoidectomy, temporal myofascial flap coating, autochondral costochondral graft. Patient evolved with 35mm AMI and 2 year post-operative follow-up. Demonstrating effectiveness and predictability of the treatment chosen, according to Kaban protocol. Keywords: TMJ ankylosis; Costochondral Graft, Interpositional Arthroplasty;Kaban Protocol                                                                 

scholarly journals Management of Traumatic Undiagnosed Condyle Fracture in Children

1970 ◽  
Vol 1 (5) ◽  
Author(s):  
Syamsul Rizal ◽  
Prasetyanugraheni Kreshanti ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Emotional Health ◽  
Correct Diagnosis ◽  
Radiological Finding ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Radiographic Examination ◽  
Tmj Ankylosis ◽  
Child Patient ◽  
Mandibular Mobility ◽  
Condyle Fracture

Background: Condyle trauma is considered to be the major cause of TMJ ankylosis but it is also the most neglected and under-managed problem in children.  TMJ ankylosis leads to be malocclusion and facial disfigurement. The aim of early treatment is to restore the mandibular mobility and to enhance further growth in order to reduce the possibility of future facial asymmetry. Patients and Methods: We report two patients with inability to open mouth few months following injury. They most probably suffered missed diagnosis condyle fracture by the previous physician. The latest physical examination and radiological finding shows the mandible was micrognathic and unilateral TMJ ankylosis was confirmed. A sequential protocol of TMJ ankylosis management based on aggressive resection of ankylotic mass was performed and followed withphysiotherapy.Result: In 2 month-follow up, both patients showed significant improvement in mouth opening and the mastication function was restored, accompanied with physical therapy to gain maximum mouth opening for at least a year.Summary: A detail history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.

O.647 Interpositional arthroplasty in TMJ ankylosis

2008 ◽  
Vol 36 ◽  
pp. S162
Author(s):  
V. Costan ◽  
D. Gogalniceanu ◽  
V.-V. Costan ◽  
C. Vicol ◽  
V. Trandaflr
Keyword(s):  
Tmj Ankylosis ◽  
Interpositional Arthroplasty

scholarly journals Conservative Approach to Unilateral Condylar Fracture in a Growing Patient: A 2.5-Year Follow Up

2012 ◽  
Vol 6 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Elif Bahar Tuna ◽  
Aysun Dündar ◽  
Abdülkadir Burak Çankaya ◽  
Koray Gençay
Keyword(s):  
Conservative Treatment ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Mandibular Growth ◽  
Fractures In Children ◽  
Facial Swelling ◽  
Direct Pressure ◽  
Condylar Head ◽  
Condylar Fractures

Condylar fractures in children are especially important because of the risk of a mandibular growth-center being affected in the condylar head, which can lead to growth retardation and facial asymmetry. The purpose of this article is to follow up the two and half year clinical and radiological evaluation of the conservative treatment of a 10 year-old patient, who had a unilateral green-stick type fracture. The patient presented with painful facial swelling localized over the left condylar region, limited mouth-opening and mandibular deviation to the left. Panoramic radiography and computed tomography confirmed the diagnosis of incomplete fracture on the left condyle with one side of the bone fractured and the other bent. Closed reduction was chosen to allow for initial fibrous union of the fracture segments and remodeling with a normal functional stimulus. A non-rigid mandibular splint was applied in order to remove the direct pressure on the fracture side of the mandible. Clinical and radiologic examination after 30 months revealed uneventful healing with reduction of the condylar head and remodeling of the condylar process following conservative treatment.

scholarly journals Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Seung-Hyun Rhee ◽  
Seung-Hak Baek ◽  
Sang-Hun Park ◽  
Jong-Cheol Kim ◽  
Chun-Gi Jeong ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Virtual Surgery ◽  
Computer Assisted ◽  
Lower Margin ◽  
Tmj Ankylosis ◽  
Reconstruction Surgery ◽  
Joint Reconstruction ◽  
Virtual Surgical Planning ◽  
Surgical Guides ◽  
Cad Cam

Abstract Backgrounds The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

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 FIBROUS ANKYLOSIS OF TEMPOROMANDIBULAR JOINT: PRESENTING WITH SUDDEN ONSET COMPLETE INABILITY TO OPEN MOUTH.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Rupesh Kumar Namdev
Keyword(s):  
Ct Scan ◽  
Temporomandibular Joint ◽  
Facial Asymmetry ◽  
Sudden Onset ◽  
Complete Fusion ◽  
Tmj Ankylosis ◽  
Mandibular Movements ◽  
Joint Ankylosis ◽  
Underlying Pathology

The temporomandibular joint makes it possible to open and close your mouth, as involving chewing, swallowing, speaking, and yawning activity.  Ankylosis of the Temporomandibular joint which includes partial or complete fusion of the joint with resulting restricted opening of mouth, restricted mandibular movements (hypomobility) with deviation to the affected side on opening of the mouth.  The pathology is multifactorial and restoration of function usually involves surgical intervention and dependence on the exact pathology situated at the root of pons.  It is essential to evaluate the underlying pathology, its degree for proper planning of surgery and follow-up.  3-D CT scan of facial bones provide a reliable and consistent diagnosis and evaluation for temporomandibular joint ankylosis.  Keywords: TMJ, ankylosis, 3-D CT scan, facial asymmetry.

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