The sequential treatment of temporomandibular joint ankylosis with secondary deformities by distraction osteogenesis and arthroplasty or TMJ reconstruction

Zhang, W.; Yang, Xiao; Zhang, Y.; Zhao, Tianlan; Jia, Junqi; Chang, Shiping; Liu, Y.; Yu, Bo; Chen, Y.; Ma, Qin

doi:10.1016/j.ijom.2018.01.022

“…(12,24,32) Re-ankylosis in this study was mainly due to lack of compliance with the mouth opening exercises as also reported by many authors explaining that recurrence was mainly related to inadequate performance of physiotherapy by the patient. (1,30,33) In addition, Cho et al (34) reported that the narrow gap width, as performed in this study, carries the risk of re-ankylosis. This explaining why both groups showed a decrease in MIO values in the second year of follow-up.…”

Section: Discussionsupporting

confidence: 49%

“…Many authors recommended gum chewing, finger stretching and mouth opening exercises for up to one year. (5,22,29) Therefore, it was essential to instruct the patients of this study to continue the jaw exercises for a minimum of six months and to be maintained for two years to prevent recurrence, as also advised by Zhang et al (30) In addition, the severity of the ankylosis plays another role in the recurrence rate, as many authors observed that relapse usually occurs in Sawhney type IV ankylosis (4,9) and more common in bilateral cases. (35) Similar results were also observed in this study as the three recurred cases are bilateral with Sawhney Class IV.…”

Section: Discussionmentioning

confidence: 98%

“…(13) In addition, immediate physiotherapy may lead to excessive strain on the muscles that induces intensive pain during mouth opening; making the patient is less likely to cooperate. (30,31) For this reason, many authors prefer to wait for a period of 5 to 10 days to allow subsidence of pain and edema and allow initial healing of the soft tissues before starting jaw mobilization. (2,3,9,13,14) This waiting period had a great effect on the results of this study, as patients of group 1 cannot tolerate aggressive exercise immediately after surgery, which is reflected by the significant difference of the VAS at the first day of physiotherapy and at two weeks when compared to the patients in group 2 who tolerated the physiotherapy much better (Pvalue = 0.00006 and 0.03, respectively).…”

Section: Discussionmentioning

confidence: 99%

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

2020

Al-Azhar Journal of Dental Science

0

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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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“…Many authors recommended gum chewing, finger stretching and mouth opening exercises for up to one year. (5,22,29) Therefore, it was essential to instruct the patients of this study to continue the jaw exercises for a minimum of six months and to be maintained for two years to prevent recurrence, as also advised by Zhang et al (30) In addition, the severity of the ankylosis plays another role in the recurrence rate, as many authors observed that relapse usually occurs in Sawhney type IV ankylosis (4,9) and more common in bilateral cases. (35) Similar results were also observed in this study as the three recurred cases are bilateral with Sawhney Class IV.…”

Section: Discussionmentioning

confidence: 98%

Immediate versus delayed physiotherapy protocol after the management of temporomandibular joint ankylosis by conservative gap arthroplasty09

Mohamed

¹

2020

Al-Azhar Journal of Dental Science

0

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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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“…O tratamento desse distúrbio articular apresenta diferentes modalidades de execução como a artroplastia de gap, artroplastia interposicional, prótese articular e distração osteogênica, dentre outros (Rajurkar et al, 2017). Alguns cirurgiões recomendam que a artroplastia e distração osteogênica sejam realizadas durante a mesma fase, a fim de melhorar a restrição na abertura da boca e deformidade maxilofacial simultaneamente, evitando assim uma segunda cirurgia (Zhang et al, 2018).…”

Section: Anquilose óSseaunclassified

Distúrbios intracapsulares da articulação temporomandibular: da semiologia à terapêutica: uma revisão de literatura

Silva

¹

,

Viana

²

,

Medeiros

³

et al. 2021

RSD

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Introdução: As disfunções temporomandibulares (DTM’s) são condições capazes de afetar diretamente a anatomia e as características funcionais da articulação temporomandibular (ATM). Elas podem ser classificadas conforme as estruturas afetadas em: Disfunção Muscular ou DTM extracapsular, quando envolve componentes do sistema mastigatório como os músculos e Disfunção Articular ou DTM intracapsular, quando afeta diretamente a ATM. Objetivo: Este trabalho consiste em uma revisão da literatura que objetiva descrever fatores etiológicos, sintomatologia, sinais clínicos, métodos de diagnóstico e modalidades de tratamento existentes dos distúrbios intracapsulares da ATM. Metodologia: Realizou-se uma busca nas bases de dados eletrônicas: PubMed, SciELO e Google Acadêmico, através do rastreio de artigos publicados entre 2005 e 2020, além de livros considerados proveitosos para o conteúdo deste estudo. Resultados: Os distúrbios intracapsulares da ATM estão associados a uma etiologia multifatorial, podendo apresentar sintomas e sinais clínicos semelhantes entre si, à exemplo, dor orofacial de intensidade variável, limitação dos movimentos mandibulares e ruídos articulares. Os exames de imagem são decisivos para o diagnóstico clínico dos distúrbios. Em relação aos tratamentos, os conservadores são preconizados e caso não mostrem eficácia, técnicas cirúrgicas são preconizadas. Conclusão: o papel do cirurgião-dentista no atendimento primário do paciente com DTM é imprescindível para um melhor prognóstico terapêutico, refletindo, sobretudo, na redução das cronificações da doença, visto que o diagnóstico precoce e o início de um tratamento que induza a adaptação da articulação frente às desordens podem impedir a evolução para quadros clínicos mais severos, como doenças degenerativas.

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The sequential treatment of temporomandibular joint ankylosis with secondary deformities by distraction osteogenesis and arthroplasty or TMJ reconstruction

Cited by 26 publications

References 18 publications

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

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

Immediate versus delayed physiotherapy protocol after the management of temporomandibular joint ankylosis by conservative gap arthroplasty09

Distúrbios intracapsulares da articulação temporomandibular: da semiologia à terapêutica: uma revisão de literatura

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