• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.1
• /
• pp.60-72
• /
• 1995

Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.72-76
• /
• 2010

Osteochondroma is the one of the most benign tumors of the axial skeleton, but is rarely found in the facial bones. Typical facial features of condylar osteochondroma include striking facial asymmetry, malocclusion with openbite on the affected side, and prognathic deviation of the chin and crossbite to the contralateral side. In this case, twenty four year-old female showed facial asymmetry, chin deviation, openbite on the affected side but have no symptoms of pain or dysfunction. Concomitantly she had maxillary occlusal cant and hemimandibular hypertrophy. Panoramic radiograph showed radiopaque mass on right mandibular condyle extended along the lateral pterygoid muscle. Computed tomogram demonstrated enlarged condylar head and bony spur on posteromedial side of condyle and 99Tc bone scintigraphy showed a focal hot image. These findings were correspond with osteochondroma. The lesion was treated with condylectomy and residual facial asymmetry was corrected with 2-jaw orthognathic surgery. Herein, we report a case of osteochondroma of the mandibular condyle and accompanying facial asymmetry.

• The Journal of the Korean dental association
• /
• v.10 no.3
• /
• pp.145-148
• /
• 1972

The authors have observed and treated the two patients with true bony ankylosis of temporomandibular joint in 16 years old school boy and 24 years old korean male. The ankylosed patients were treated by condylectomy and arthroplasty such as resin condylar head graft having been made into acrylic resin. 1. In 16 years old school boy, temporoandibular ankylosis of left side was surgical_y approached by condylectomy including coronoid process and posterior border of ramus and resin condylar head graft by means of interosseous wiring. 2. In 24 years old korean male, bilateral temporomandibular ankylosis was treted by bilateral condylectomies and resin condylar head grafts. 3. The mouth opening has been continued as 3-5cm since 13 months and 8 months before and facial appearances were very excellent.

• The korean journal of orthodontics
• /
• v.49 no.6
• /
• pp.413-426
• /
• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• The Journal of the Korean dental association
• /
• v.25 no.7 s.218
• /
• pp.657-664
• /
• 1987

The purpose of this article is to report a case of internal derangement of TMJ which was successfully managed with surgical and occlusal treatment. The Obtained results were summarized as follow: 1. The patient surgically operated via high condylectomy with meniscoplasty to correct anteriorly displaced meniscus. 2. During operation, the junction area of bilamina zone and meniscus was easily identified and resected using microscopy. 3. The mandible was relocated into therapeutic position with occlusal splint. 4. The occlusal rehabilitation with selective grinding and prosthodontic treatment was done so that the new patient's intercuspal position should correspond to the therapeutic position.

• The Journal of the Korean dental association
• /
• v.19 no.4 s.143
• /
• pp.375-380
• /
• 1981

Unilateral bony ankylosis of temporomandibular joint is not extremely rare. Treatment in all cases should be surgical. Considerable difficulty has been encountered by surgeons in the judgment of the planning of the treatment for anklosis; either by gap arthroplasty or by interposition arthroplasty. A recent review of the literautre reveals that many authors reported more of the interposition arthroplasty treatment because of no recurrence and the excellent results obtained. This 22-year-old Korean female, who had suffered from unilateral temporomandibular joint recurrent anklosis, was received an operation of ramus osteotomy followed by interpositional arthroplasty with using of thin gold plate. She formerly was received condylectomy twice at the age of 8 and 9, under the diagnosis of unilateral bony ankylosis due to trauma. My experience with alloplasty in unilaterally recurrent ankylosed T-M joint is presented here for her general and oral functional condition proved to be satisfactory after 4 years follow-up.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.2
• /
• pp.215-220
• /
• 1994

In the case of the trauma on the maxillofacial region occurred, we think that one of the most important thing is recovery of the function as well as reconstruction of the anatomical form. Especially, it has been that the structure of the surrounded temporomandibular joint has a great possibility to cause mouth opening limitation when a bit of displacement is caused. Therefore, in the case of the trauma on mid-face we think that we treat it after complete evaluate condition of soft and hard tissue surrounding the articular disc as well as fracture site. We report results of our study, since we obtained good results from our study concerning the refixation of the zygomatic arch, high condylectomy, coronoidectomy and myotomy for the patient being suffered from the arthrosis of the temporomandibular joint caused by insufficient fracture treatment of zygomatic arch and coronoid process.

• The Journal of the Korean dental association
• /
• v.22 no.4 s.179
• /
• pp.333-338
• /
• 1984

This is to report a case of traumatic bone cyst which occurred in the left condylar head of the mandible. It is a very rare case and the prognosis after operation seems to be fair, therefore we report as follows. 1. The pt, a 49 year-old female, has been suffering from difficulties of mastication with disfiguration of face due to deviation of mandible to the right side for 20 years. 2. Histopathologic findings showed the figure of multilocular bony cysts contained with fibrous tissue, osteoid tissue and many hematopoietic cells 3. Roentgenographic features showed well circumscribed radiolucent lesion with some radiopaque area. 4. After clinical evaluation, condylectomy was done to remove the lesion. 5. After the operation, the esthetic problem and masticatory functions were improved.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.21 no.3
• /
• pp.317-323
• /
• 1999

TMJ ankylosis is defined as a mobile disorder of jaw such as mouth opening limitation, limitation of anterior or/and lateral movement of TMJ. Kazanjian published first clinical report about classification of TMJ ankylosis dividing with intracapsular ankylosis and extracapsular ankylosis. TMJ ankylosis is resulted from trauma, infection, metastatic tumor, irradiation, burn and etc. When TMJ ankylosis is manifested in growing period, it affects to functional disorder and development and position of mandible, so it can result in maxillofacial deformity such as facial asymmetry, micrognathia, malocclusion. For treatment of TMJ ankylosis, various surgical interventions were devised ; condylectomy, gap arthroplasty, interpositional arthroplasty and TMJ reconstruction. So, we report our results with documental study and cases of true ankylosis in our department.

• Imaging Science in Dentistry
• /
• v.45 no.2
• /
• pp.103-108
• /
• 2015

Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.