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Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

Cited 5 time in Web of Science Cited 5 time in Scopus
Issue Date
2019-04-19
Publisher
Springer Open
Citation
Maxillofacial Plastic and Reconstructive Surgery, 41(1):18
Keywords
Temporomandibular joint (TMJ) ankylosisGap arthroplastyInterpositional graftInterocclusal splint (IOS)Maximum mouth opening (MMO)
Abstract
Background
Temporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis.

Methods
A total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period.

Results
All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOSs guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery.

Conclusions
Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.
ISSN
2288-8586
Language
English
URI
https://hdl.handle.net/10371/153247
DOI
https://doi.org/10.1186/s40902-019-0200-x
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College of Dentistry/School of Dentistry (치과대학/치의학대학원)Dental Research Institute (치학연구소)Journal Papers (저널논문_치학연구소)
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