• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권1호
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• pp.95-102
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• 2001

Temporomandibular ankylosis is defined as a situation in which the condyle is fused to the fossa by bone or fibrous tissue. Conditons such as trauma, infection, or systemic disease may predispose to various types of ankylosis, bringing about different levels of limitation in mandibular movement. Most patients with temporomandibular ankylosis are associated with limitation of maximal mouth opening, deviation of the chin toward the affected side, impaired occlusion, chronic pain, compromised oral hygiene, severe facial asymmetry & impeded mandibular molar eruption occurring in childhood. Several techniques to release ankylosis have been described in the literature, showing variable and often unsatisfactory results. The most frequently used operations are gap arthroplasty, interpositional arthroplasty, and exicision and joint reconstruction with autogenous or alloplastic materials. We have managed the two patients of TMJ ankylosis. They had previously TMJ surgery and we treated with gap arthroplasty & active physial therapy. We have obtained favorable results and report these cases with literatures review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.55-65
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• 2005

Most patients with temporomandibular disorder can be treated conservatively. However, open TMJ surgery can be needed in some patients. We analysed the patients with TMD which open surgery has performed since 1998. Open surgery was carried out in 8 patients. Age ranged from 22 to 61 years, with a mean of 42.8years. All patients were male. Final diagnosis was obtained based upon clinical, radiographic and operative finding as follows; habitual luxation, bony ankylosis, traumatic arthritis, disc displacement with destructive change, disc displacement and adhesion. Etiologic factors included trauma(4), infection(2), and unknown(2). Open surgery included arthroplasty with either of condylectomy, eminectomy, meniscoplasty, capsurrohaphy. All patients were recovered uneventfully without severe complications. Some mouth opening limitation and mouth opening deviation remained. Postoperative aggressive physical therapy and careful follow up were performed. In conclusion, open TMJ surgery must be considered in organic disease such as ankylosis, tumor and TMD without favorable recovery after long-term conservative therapy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권2호
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• pp.40-46
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• 1989

출생 전${\cdot}$후 악관절의 외상 또는 감염은 과두 성장을 방해하며 편측으로 발생하는 경우 하악골의 비대칭 성장을 초래하여 심한 안모 변형과 부정교합을 유발하거나 악관절 유착의 주된 원인이 된다. 역사적으로 관절 유착은 과두절단술에서부터 연골이식, 진피이식, 금속과두 이식, 관절 성형술, 관절과 이식물 삽입에 이르기까지 매우 다양한 방법에 의해 치료되어 왔으며 하악운동이 보장되고 정상적인 기능을 회복하는데는 어떤 술식이라도 만족스런 결과를 가져다줄 수 있다. 이에 저자는 편측성 악관절 강직증 및 비대칭 안모를 가진 환자에서 과두절제술 후 금속 과두이식을 이용한 악관절 재건과 하악 골체부 절단술 및 C-sliding 절단술, 하악지 수직 골절단술, Medpor를 이용한 증식술로 개구기능과 비대칭 안모를 개선하여 비교적 만족할 만한 결과를 얻었기에 그 치험례를 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.544-549
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• 2000

악관절 강직증의 치료는 기술적 어려움과 높은 재발율로 인해 난관에 부딪히고 있다. 악관절 강직증은 골절제와 이종, 동종, 자가 물질을 이용한 악관절 재건술로 치료를 해왔다. 측두근-근막피판은 그것의 해부학적, 지리적, 기능적 성질로 인해 우수한 간치 이식물질로 여겨지고 있다. 본 연구는 전이개 절개, 근돌기 절제술과 병행한 아홉개의 악관절(다섯명의 환자)강직의 치료에서 측두근-근막피판의 효율성에 대해 알아 보았다. 그 결과 측두근-근막 피판은 이상적인 간치 이식물질의 기준을 만족하는 자가물질로 여겨지며 disc의 생리적 기능을 수행하는것으로 사료된다. 그러나, 이러한 우수한 기능적 결과에도 불구하고 술후 약간의 전치부 개교경향은 또다른 문제점으로 남아있다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권6호
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• pp.544-558
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• 2006

Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture, and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.