• 제목/요약/키워드: Temporomandibular joint ankylosis

검색결과 54건 처리시간 0.02초

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

  • Rhee, Seung-Hyun;Baek, Seung-Hak;Park, Sang-Hun;Kim, Jong-Cheol;Jeong, Chun-Gi;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.41.1-41.6
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    • 2019
  • 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.

측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 대한물리치료과학회지
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    • 제5권4호
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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악관절에 이환된 류마티양관절염에 관한 방사선학적 연구 (ROENTGENOGRAPHIC STUDY OF THE TEMPOROMANDIBULAR JOINT IN RHEUMATOID ARTHRITIS)

  • 윤호중;유동수
    • 치과방사선
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    • 제14권1호
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    • pp.61-69
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    • 1984
  • For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosed as rheumatoid arthritis through the clinical, radiographic examination and laboratory findings. Temporomandibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

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제 3 대구치의 치근단 농양으로 인한 측두하악장애 (Temporomandibular Disorder Caused by Periapical Abscess of Third Molar)

  • 조은애;권정승;안형준;김성택;최종훈
    • Journal of Oral Medicine and Pain
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    • 제38권2호
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    • pp.143-147
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    • 2013
  • 측두하악장애 중 개구제한은 일반적으로 저작근, 측두하악관절의 통증, 비정복성 관절원판변위, 측두하악관절의 유착이나 강직, 저작근의 근경축 등에 의해 발생한다. 하지만 이비인후과적인 질환, 신경 및 혈관질환, 종양, 염증, 감염 등에 의해 측두하악장애와 유사한 통증 및 개구제한이 유발 될 수 있다. 따라서 병력 조사 및 임상 검사 시 이러한 이차적 질환에 대한 고려가 필요하다. 특히 초진 시 전형적인 측두하악장애의 소견을 보인다고 할지라도 적절한 치료 및 환자의 자기 관리에도 불구하고 증상의 호전이 없거나 지속적인 악화 소견을 보이는 경우에는 염증, 감염, 종양 등의 가능성에 관한 포괄적인 재평가가 필수적이다. 본 증례에서는 제 3 대구치의 치근단 농양이 익돌하악간극(pterygomandibular space)으로 확산되어 발생한 내익돌근(medial pterygoid muscle)의 통증 및 개구제한에 관하여 경험하였기에 이를 보고하고자 한다.

하악 과두 골절과 측두하악관절과의 관계 (Correlation Between Mandibular Condylar Process Fracture and Temporomandibular Joint)

  • 문철웅;김수관;오지수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권5호
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    • pp.488-492
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    • 2010
  • This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

측두근-근막피판을 이용한 악관절 강직증의 외과적 재건 (INTERPOSITIONAL ARTHROPLASTY OF TEMPOROMANDIBULAR JOINT ANKYLOSIS WITH TEMPORALIS MYOFASCIAL FLAP)

  • 남정순;이용규;권대근;김종배
    • 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.

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Bone remodeling of the fibula segment as a form of neocondyle after free vascularized bone transfer: a report of two cases

  • Han Ick Park;Hoon Je Chang;Jee-Ho Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권6호
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    • pp.354-359
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    • 2023
  • The temporomandibular joint is a unique structure composed of the joint capsule, articular disc, mandibular condyles, glenoid fossa of the temporal bone, surrounding ligaments, and associated muscles. The condyle is one of the major components of a functional temporomandibular joint. Reconstruction of large mandibular defects involving the condyle is a surgical challenge for oral and maxillofacial surgeons. To restore large mandibular defects, there are different options for free flap method such as fibula, scapula, and iliac crest. Currently, the vascularized fibula free flap is the gold standard for reconstruction of complex mandibular defects involving the condyle. In the present report, neocondyle regeneration after mandible reconstruction including the condyle head with fibula free flap was evaluated. In this report, two patients were evaluated periodically, and remodeling of the distal end of the free fibula was observed in both cases after condylectomy or mandibulectomy. With preservation of the articular disc, trapezoidal shaping of the neocondyle, and elastic guidance of occlusion, neocondyle bone regeneration occured without ankylosis. Preservation of the articular disc and maintenance of proper occlusion are critical factors in regeneration of the neocondyle after mandible reconstruction.

소아에서 하악과두 골절의 보존적 치료 후 골개조 (REMODELLING AFTER CONSERVATIVE TREATMENT OF THE MANDIBULAR CONDYLAR FRACTURES IN CHILDREN)

  • 유선열;황웅;양규호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.49-55
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    • 2004
  • The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

Outcome analysis of biplanar mandibular distraction in adults

  • Chattopadhyay, Debarati;Vathulya, Madhubari;Jayaprakash, Praveen Ambadivalappil;Kapoor, Akshay
    • 대한두개안면성형외과학회지
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    • 제22권1호
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    • pp.45-51
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    • 2021
  • Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

개구장애 환자의 병인, 감별진단 및 치료방식에 대한 임상연구 (CLINICAL STUDY ON THE ETIOLOGY, DIFFERENTIAL DIAGNOSIS AND TREATMENT OF TRISMUS)

  • 강희제;황대석;김용덕;신상훈;김욱규;김종렬;정인교
    • 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.