Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis

  • Malhotra, Vijay Laxmy (Department of Dentistry, Shaheed Hasan Khan Mewati (SHKM), Govt. Medical College) ;
  • Singh, Virendra (Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Medical Sciences (PGIMS)) ;
  • Rao, JK Dayashankara (Department of Oral and Maxillofacial Surgery, SGT Dental College & Hospitals) ;
  • Yadav, Sunil (Department of Dentistry, BPS Govt. Medical College for Women) ;
  • Gupta, Pranav (Department of Dentistry, Government Medical College) ;
  • Shyam, Radhey (Department of Dentistry, Shaheed Hasan Khan Mewati (SHKM), Govt. Medical College) ;
  • Kirti, Shruti (Department of Dentistry, Shaheed Hasan Khan Mewati (SHKM), Govt. Medical College)
  • Received : 2018.05.17
  • Accepted : 2018.07.09
  • Published : 2019.06.30
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Abstract

Objectives: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. Materials and Methods: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (${\geq}35mm$) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. Results: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. Conclusion: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.

Keywords

References

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