Maxillofacial Plastic and Reconstructive Surgery

  • 제41권
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  • Pages.18.1-18.10
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  • 2019
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
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Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

  • Park, Min Woo (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Eo, Mi Young (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Seo, Bo Yeon (Department of Orthodontics, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Nguyen, Truc Thi Hoang (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kim, Soung Min (Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University)
  • 투고 : 2019.01.07
  • 심사 : 2019.03.21
  • 발행 : 2019.12.31
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초록

Background: Temporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis. Methods: A total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period. Results: All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS's guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery. Conclusions: Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.

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참고문헌

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피인용 문헌

  1. Coronoidoplasty in TMJ ankylosis treatment vol.13, pp.8, 2020, https://doi.org/10.1136/bcr-2020-235698
  2. Silicon Interpositional Arthroplasty for Temporo-mandibular Joint Ankylosis vol.73, pp.1, 2019, https://doi.org/10.1007/s12070-020-02063-w
  3. Classification and surgical management of temporomandibular joint ankylosis: a review vol.47, pp.4, 2019, https://doi.org/10.5125/jkaoms.2021.47.4.239
  4. Quantitative Asymmetry Assessment between Virtual and Mixed Reality Planning for Orthognathic Surgery-A Retrospective Study vol.13, pp.9, 2021, https://doi.org/10.3390/sym13091614