• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.60-72
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• 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.

• 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.

• 대한치과의사협회지
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• 제42권6호통권421호
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• pp.409-413
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• 2004

Tooth ankylosis is frequently resulted from trauma. If indicated, surgical correction is useful osteotomy is one of the method orthodontic surgery that realigns each tooth to the desirable position by using interdental alveolotomy. This method is being adapted when conventional orthodontic of tooth ankylosis on the anterior maxilla via unitooth osteotomy with literature review.

• 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.

• 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 Periodontal and Implant Science
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• 제31권1호
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• pp.193-209
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• 2001

The prognosis of transplanted teeth is strongly related with periodontal healing. Several experimental studies showed that the application of enamel matrix derivatives on periodontitis-affected root surfaces resulted in periodontal regeneration. The purpose of this study was to determine the effect of enamel matrix derivatives on periodontitis-affected root surfaces prior to transplantation in dogs. Class III Furcation defects were surgically created on the left second, the third and the fourth premolar in the mandibles of nine mongrel dogs and experimental periodontitis was induced by placing small cotton pellets into defects for 3 weeks. Periodontitis-affected roots were treated by scaling and planing and the coronal portions were removed. Each root was extracted and implanted into recipient bed prepared in the contralateral premolar area. The transplanted roots were grouped according to the treatment modalities; Group I- roots treated with saline only, Group II- roots conditioned by neutral EDTA, and Group III- roots conditioned by neutral EDTA and enamel matrix derivatives ($EMDOGAIN^{(R)}$, BIORA Co., Sweden). The animals were sacrificed at 1 week, 3 weeks, and 10 weeks after transplantation and decalcified specimens were prepared for histologic examination. In Group I, healing was most frequently characterized by root resorption and ankylosis. In Group II, with root resorption and ankylosis in a few specimens, connective tissue attachment was partly seen on denuded root surface, but no cementum formation was seen. In Group III, there was regeneration by new cementum and periodontal ligament on denuded root surface, although slight root resorption and ankylosis were found in a few specimens. This result suggests that enamel matrix derivatives treatment on periodontitis-aggected root surface could reduce the frequency of root resorption and ankylosis and contribute to periodontal regeneration, and might be useful for autologous transplantation.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.61-67
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• 2023

Purpose: The aim of this study was to objectively detect simulated tooth ankylosis using a novel method involving cone-beam computed tomography (CBCT). Materials and Methods: Tooth ankylosis was simulated in single-rooted human permanent teeth, and CBCT scans were acquired at different current levels (5, 6.3, and 8 mA) and voxel sizes (0.08, 0.125, and 0.2). In axial reconstructions, a line of interest was perpendicularly placed over the periodontal ligament space of 21 ankylosed and 21 non-ankylosed regions, and the CBCT grey values of all voxels along the line of interest were plotted against their corresponding X-coordinates through a line graph to generate a profile. The image contrast was increased by 30% and 60% and the profile assessment was repeated. The internal area of the resulting parabolas was obtained from all images and compared between ankylosed and non-ankylosed regions under different contrast enhancement conditions, voxel sizes, and mA levels using multi-way analysis of variance with the Tukey post hoc test(α=0.05). Results: The internal area of the parabolas of all non-ankylosed regions was significantly higher than that of the ankylosed regions(P<0.05). Contrast enhancement led to a significantly greater internal area of the parabolas of non-ankylosed regions (P<0.05). Overall, voxel size and mA did not significantly influence the internal area of the parabolas(P>0.05). Conclusion: The proposed novel method revealed a relevant degree of applicability in the detection of simulated tooth ankylosis; increased image contrast led to greater detectability.

• 대한치과교정학회지
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• 제32권4호
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• pp.257-264
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• 2002

유착된 치아는 교정력으로 이동되지 않으므로 대부분 발치를 하였지만 어린나이에 치아를 발거하면 치아의 결손과 이에 수반되는 치조골의 소실 때문에 심미적으로 매우 불량해진다. 저자들은 임상적, 방사선 소견으로 유착된 것이 확인된 상악 중절치와 측절치를 각각 의도적인 탈구와 단일치아 골절단술을 시행한 후 약하고 지속적인 힘을 가하여 비교적 양호한 결과를 얻어 이에 대해 보고하고자 한다.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.113-118
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• 2002

Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

• Imaging Science in Dentistry
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• 제30권3호
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• pp.217-222
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• 2000

A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.