颞下颌关节强直治疗方法分析

目的 探讨治疗颞下颌关节强直并有效防止复发的方法.方法 对3例外伤性颞下颌关节强直病例,除将残余关节盘复位缝合外,分别用喙突、残留髁状突及喙突联合钛金属关节头恢复颞下颌关节结构.结果 病例1术后1年复查,张口度为2.5 cm,咬合时下颌偏术侧.病例2术后1年复查,张口度为3.7 cm,咬合关系正常.病例3术后3个月复查,张口度为3.9 cm,前牙轻度开(牙合).结论 恢复关节的"正常"解剖结构,使残余的关节盘复位,保留残留的髁状突,并使其复位固定,有望提高颞下颌关节强直患者手术疗效,减少复发.

Study of Surgical Treatment of Temporomandibular Joint Ankylosis

Objective Several surgical procedures were used to treat temporomandibular joint(TMJ) ankylosis,to restore the structure of TMJ and to prevent recurrence of TMJ ankylosis.Methods Three patients with traumatic TMJ ankylosis with 4-10 years' duration were treated.Their preoperative maximal mouth opening was from 0-0.8 cm.In the first case,the coronoid process was used to replace the condyle.In the second case,the condylar stump was reused.In the third,the coronoid process was implanted to replace the condyle in one side and the titanium prosthesis in the other side.The remain disc was sutured with articular capsule in all cases.Results Follow-up was performed from 3 months to 1 year.The patient's maximal mouth opening was(2.5 cm),3.7 cm and 3.9 cm in proper order.The first patient's occlusive relationship lead to the operating side;the second patient has normal occlusive relationship and the third has open bite malocclusion.Conclusion It is beneficial to prevent recurrence of TMJ ankylosis,providing the normal structure of TMJ is restored,including preservation and replacement of the conclylar stump and the remained disc.