No abstract

Arthrocentesis is the surgical treatment of choice for temporomandibular joint (TMJ) disorders.Many studies of arthrocentesis have reported an excellent clinical outcome. No previous report, however, has described the use of multiple arthrocenteses to treat TMJ dysfunction. We evaluated the efficacy of two consecutive arthrocenteses followed by mouth opening exercises during treatment with non-steroidal anti-inflammatory drugs (NSAID) as a primary treatment for TMJ osteoarthritis.The subjects of this study were selected from a consecutive series of patients with unilateral moderate-to-severe TMJ dysfunction newly diagnosed at the TMD Clinic, Aichi-Gakuin University Hospital during a 1-year period.Thirty-six patients with osteoarthritis as documented by magnetic resonance imaging underwent two consecutive arthrocenteses at a 2-week interval followed by mouth opening exercises and NSAID administration. The patients were postoperatively examined every 2 weeks for 12 weeks. Clinical evaluations included pain-related measures on visual analog scales (VAS, 0-100) and range of motion. At the completion of treatment, patients had sustained pain relief and improved mouth opening. Factors that affected clinical outcome of TMJ function were assessed.Of the 36 patients who underwent two consecutive arthrocenteses, 28 showed substantially improvement on follow-up at 12 weeks. The range of motion (median) increased from 28 mm to 39.5 mm. VAS pain-scores on mouth opening and chewing significantly decreased from 54 and 53 to 10 and 7, respectively. The interference score for activities of daily life also decreased from 33.5 to 9. A longer duration of TMJ symptoms before the procedure was found to affect the outcome.

Arthrocentesis is the surgical treatment of choice for TMJ disorders. Many studies of arthrocentesis have been performed, with excellent clinical outcomes. No previous study has used multiple arthrocenteses to

We report a surgical technique for habitual temporomandibular joint dislocation.Cortical bone was shaved at the anterior slope of the tubercle, and a piece of an autogenous bone block was grafted to augment the tubercle. The grafted bone was fixed with a titanium plate and screws. This method preserved the original posterior slope of the tubercle, permitting smooth condylar movement. We used this technique in two patients and followed them for 15 and 5 years, respectively. Postoperative examinations showed no resorption of the grafted bone and no recurrence of dislocation in either patient.

A dismasking flap is a skin incision technique in which a circumpalpebral incision is combined with a conventional coronal incision to establish a large surgical field on the face. We describe a patient in whom an osteochondroma arising in the mandibular condyle was resected using a dismasking flap. A 42-year-old woman with a left temporomandibular joint tumor was undergoing treatment at our hospital' s Department of Otolaryngology when she was referred to our department because of trismus. Trismus and pain exacerbated during jaw movement. The maximum mouth opening was only 20 mm. The patient gave informed consent for the temporomandibular joint tumor to be resected under general anesthesia. Surgery was performed in collaboration with the Department of Neurosurgery and of Plastic Surgery. Dismasking flap procedures were performed, and the zygomatic arch was transiently dissected to expose the tumor. The tumor was excised with the mandibular condyle. The site of mandibular condyle resection was immediately reconstructed using an artificial condyle. The histopathological diagnosis of the excised tumor was osteochondroma. As of 1 year 8 months after surgery, the patient' s range of mouth opening is 35 mm, and there has been no recurrence of the tumor.