Surgical management of ankyloses of the temporomandibular joint by a piezoelectric device

Spinelli, Giuseppe; Valente, Domenico; Mannelli, Giuditta; Raffaini, Mirco; Arcuri, Francesco

doi:10.1016/j.jcms.2016.12.004

Cited by 16 publications

(12 citation statements)

References 27 publications

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“…In all cases, precision ostectomy has been performed using a piezotome with bone cutting tips. The piezotome was demonstrated to be an effective surgical tool that allows for accurate bone cutting with reduced risk of hemorrhage and damage to surrounding soft tissues and neurovascular structures (6,19,20). The piezotome is an innovative surgical instrument that uses high frequency (25-35 kHz) vibration of a metallic tip to selectively cut bone while sparing neurovascular structures and soft tissues (19).…”

Section: Discussionmentioning

confidence: 99%

“…The piezotome is an innovative surgical instrument that uses high frequency (25-35 kHz) vibration of a metallic tip to selectively cut bone while sparing neurovascular structures and soft tissues (19). Use of a piezosurgical unit also results in more rapid healing (19,20). The piezotome can also be used to perform osteoplasty with specialized bone surgery tips that allow for smooth shaping and contouring of bone margins.…”

Section: Discussionmentioning

confidence: 99%

“…The piezotome can also be used to perform osteoplasty with specialized bone surgery tips that allow for smooth shaping and contouring of bone margins. The disadvantages of the piezosurgical unit are that it tends to be slower than traditional oscillating saws or cutting burs and a learning curve exists for the operator of the instrument (19,20). Regardless, given the delicate nature of the surgery and the challenging anatomic location, the authors recommend the use of a piezotome when performing gap arthroplasty in cats.…”

Section: Discussionmentioning

confidence: 99%

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Temporomandibular Joint Gap Arthroplasty in Cats

2020

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Temporomandibular joint (TMJ) ankylosis is defined as fibrous or bony fusion of the mandibular head of the condylar process and the mandibular fossa of the squamous part of the temporal bone. Ankylosis of the TMJ may be intraarticular, extraarticular, or both. The objective of this report is to describe the surgical planning, technique, and outcome of gap arthroplasty for extensive TMJ ankylosis in cats. Client-owned cats (n = 7) were examined clinically and surgical planning included the use of cone-beam computed tomography (CBCT) and tridimensional (3D) printed models. In six of the seven cats, temporary tracheostomy intubation was required. Gap arthroplasty included zygomectomy, coronoidectomy, condylectomy, as well as fossectomy (removal of the mandibular fossa of the temporal bone) and was performed using a piezosurgical unit. In all seven cats, gap arthroplasty was performed without surgical complications. In addition, a clinically acceptable mouth opening was achieved in all cases. However, a noticeable mandibular instability was observed. Medium-term follow-up demonstrated acceptable quality of life with one case of recurrence of ankylosis requiring repeated bilateral surgery, and a second case with recurrence of ankylosis not requiring surgical intervention at the time of manuscript preparation. We concluded that TMJ gap arthroplasty in cats is a salvage procedure indicated in cases of severe intraarticular and extraarticular ankylosis. Diagnostic imaging by means of CBCT and 3D printing are essential for precise surgical planning. The use of a piezosurgical unit allows for safe and precise ostectomy. Clinically, despite the resulting mandibular instability, appropriate prehension of food and water was possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Temporomandibular Joint Gap Arthroplasty in Cats

2020

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“…Many authors observed that restoration of MIO and prevention of re-ankylosis depend mainly on radical resection of the ankylotic mass, aggressive postoperative physiotherapy, and good patient's cooperation with regular follow-up, regardless the selected surgical technique. (11,(24)(25)(26) The ideal width of the gap arthroplasty remains controversial. Many authors stated that to prevent re-ankylosis, aggressive bone removal of at least 1.5 cm is required.…”

Section: Discussionmentioning

confidence: 99%

Immediate versus Delayed Physiotherapy Protocol after the Management of Temporomandibular Joint Ankylosis by Conservative Gap Arthroplasty

2020

Al-Azhar Journal of Dental Science

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Objective: The aim of this study was to evaluate the effect of immediate and delayed physiotherapy protocol on the maximum interincisal opening (MIO), pain magnitude during physiotherapy, and rate of re-ankylosis, following the release of temporomandibular joint ankylosis (TMJa) by conservative gap arthroplasty. Subjects and methods: Twenty four patients with TMJa were treated with conservative gap arthroplasty. They were divided into two equal groups: In group 1, physiotherapy was started 24 hours after surgery. In group 2, physiotherapy was initiated after one week postoperative. MIO, pain magnitude by visual analogue scale (VAS), and rate of re-ankylosis were recorded. The values of MIO and VAS of both groups were compared by paired sample t-test. Results: Both groups showed significant improvement in MIO. At one week and one month postoperative, MIO showed significant difference between the two groups (P-value ≤ 0.05). At the remaining follow-up period, no significant difference was observed. By comparing the VAS of the two groups, it was significant only at the first day of physiotherapy and at two weeks (P-value ≤ 0.05). The rate of re-ankylosis was non-significant between the two groups. Conclusion: Maintenance of MIO is less dependent on the starting time of physiotherapy and more indebted to the patient cooperation with a regular physiotherapy protocol. The reduction in the VAS encourages the patients to perform more comfortable TMJ exercises.

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“…Spinelli et al . [ 10 ] reported that substantial reduction in bleeding was noted with the piezoelectric bone cutter when compared to traditional mechanical surgery during TMJ ankylosis surgery. Jose et al .…”

Section: Discussionmentioning

confidence: 99%

Management of the bilateral chronic temporomandibular joint dislocation

İşler

Çakarer

Yalcin

et al. 2018

Ann Maxillofac Surg

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Temporomandibular jaw dislocation is an uncontrolled anterior movement of the condyle beyond the articular eminence. It can occur mostly in young adults, and the symptoms are mouth opening disturbance, preauricular skin depression, tense masticatory muscles, and pain. The main purpose of the eminectomy procedure is removal of a part of the articular eminence to maintain free movement of the condyle. The surgical procedure may be performed by conventional surgery or piezosurgery. The present case report describes the management of a recurrent mandibular dislocation in a 28-year-old patient who had also treated conservatively with autologous blood injection. In this report, bilateral eminectomy was performed by piezosurgery to provide soft-tissue protection, precise cut, and optimal view of the surgical area. The management technique is discussed within the current literature.

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Surgical management of ankyloses of the temporomandibular joint by a piezoelectric device

Cited by 16 publications

References 27 publications

Temporomandibular Joint Gap Arthroplasty in Cats

Temporomandibular Joint Gap Arthroplasty in Cats

Immediate versus Delayed Physiotherapy Protocol after the Management of Temporomandibular Joint Ankylosis by Conservative Gap Arthroplasty

Management of the bilateral chronic temporomandibular joint dislocation

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