Interpositional arthroplasty of post-traumatic temporomandibular joint ankylosis: A modified method |
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| Authors: | Fangxing Zhu Yin Zhi Xiaofeng Xu Jinyang Wu Jiawen Si Jun Shi Bing Xu |
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| Affiliation: | 1. Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. National Clinical Research Center for Oral Diseases, Shanghai, China;3. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China;1. Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium;2. Division of Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain;3. Division of Paediatric Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Barcelona Children''s Hospital, Esplugues de Llobregat, Barcelona, Spain;4. Department of Maxillofacial Surgery, All for Research VZW, ZMACK Association, AZ MONICA Antwerp, Antwerp, Belgium;5. Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium;6. Department of Plastic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, United Kingdom;7. Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteits-plein 1, 2610 Antwerp, Belgium;1. The State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041, PR China;2. Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, 610041, PR China;3. Engineering Research Center of Oral Translational Medicine, Ministry of Education, Chengdu, 610041, PR China;4. National Engineering Laboratory for Oral Regenerative Medicine, Chengdu, 610041, PR China;5. Stomatology Hospital, Zhejiang University School of Medicine, 310000, PR China;1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea;2. Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Republic of Korea;1. Department of Surgery, Central Hospital of Päijät-Häme, Keskussairaalankatu 7, 15850, Lahti, Finland;2. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4 E, PO Box 220, 00029 HUS, Helsinki, Finland;3. Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, PO Box 266, 00029 HUS, Helsinki, Finland;4. Injury Epidemiology and Prevention (IEP), Turku Brain Injury Center, Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Hämeentie 11, PO Box 52, 20521, Turku, Finland;5. Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany;1. Maxillofacial Surgery and Diagnostic Science, College of Dentistry, Qassim University, Saudi Arabia;2. Anaesthesia, Intensive Care, and Pain, Faculty of Medicine for Girls, Al Azhar University, 11727, Nasr City, Cairo, Egypt;3. Oral and Maxillofacial Surgery, Faculty of Dentistry, Deraya University, Minya, Egypt;4. Dental Medicine for Girls, Al Azhar University, 11727, Nasr City, Cairo, Egypt;1. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, PO BOX 100, FI-00029, HUS, Finland;2. Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, FI-20014, Finland;3. Department of Oral and Maxillofacial Diseases, Turku University Hospital, FI-20521, Turku, Finland;4. Injury Epidemiology and Prevention (IEP), Turku Brain Injury Centre, Division of Clinical Neurosciences, Turku University Hospital and University of Turku, PO BOX 52, FI-20014, Finland;5. Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, 69120, Heidelberg, Germany;6. Department of Orthopaedics and Traumatology, Helsinki University Hospital and University of Helsinki, PO BOX 100, FI-00029, HU, Finland |
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| Abstract: | The purpose of this study was to evaluate a modified method of interpositional arthroplasty for post-traumatic temporomandibular joint ankylosis.All patients were treated with a modified interpositional arthroplasty that included: navigation-assisted accurate bone dissection with minimal removal of only 5 mm of the ankylosed bony mass, novel application of bone wax and porcine acellular dermal matrix to prevent re-ankylosis, and a unique 3D-printed splint for occlusal stabilization and gap maintaining. The pre- and post-operative physical and radiological examinations of patients were recorded during routine follow-up visits. Postoperative follow-up visits lasted at least 12 months.Twelve patients, seven males and five females, ranging from 21 years to 59 years, were enrolled in this retrospective case series. All of the twelve patients with eighteen bony ankylosed temporomandibular joints were treated by our new method. The post-operative follow-up periods ranged from 1 year to 4 years. During the follow-up visits within at least 1 year, no one manifested re-ankylosis. The mean maximum incisor opening changed from 7.4 ± 5.3 mm (p < 0.001, before surgery) to 37.6 ± 3.9 mm (p < 0.001, last follow-up visit). No sign of post-operative infection or foreign body rejection was observed during the follow-up visits. The post-operative occlusal relationship was sound and stable.It is suggested that the modified method of interpositional arthroplasty provides favorable clinical and radiographic outcomes after a short-term follow up. |
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| Keywords: | Temporomandibular ankylosis 3D print Occlusal splint Bone wax Interpositional arthroplasty |
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