Condylar surface CT value in sagittal plane before and after sagittal split ramus osteotomy

Purpose

The purpose of this study was to evaluate the relationship between computed tomography (CT) values of the condylar surface and temporomandibular joint (TMJ) disc position in the sagittal plane before and after sagittal split ramus osteotomy (SSRO) setback surgery, retrospectively.

Materials and methods

The subjects were 75 patients (150 condyles) who underwent bilateral SSRO setback surgery. They were divided into two groups (42 symmetric patients and 33 asymmetric patients). Maximum CT values (pixel values) of five points of the condylar surface and condylar height, length, fossa height, fossa length, and ramus angle in the sagittal plane were measured preoperatively and 1 year postoperatively. Disc position was classified as anterior disc displacement, anterior type, fully covered type, and posterior type, both pre- and postoperatively, using magnetic resonance imaging (MRI).

Results

Postoperative value was significantly higher than preoperative one in CT value of 135° (P = 0.0199) and 180° (0.0363), in the non-deviation side in the asymmetry group. The anterior disc displacement group was significantly larger than those of some other areas pre- and postoperatively in the CT value of 0° point (P < 0.05).

Conclusions

This study suggested that CT value of the posterior site of the condylar surface could change in the non-deviation side in the asymmetry group after 1 year SSRO, and the condyle with anterior displacement showed high CT value at the anterior site of the condyle before and after surgery.

     

Evaluation of the relationships between contrast-enhanced magnetic resonance characteristics and joint pain in patients with temporomandibular disorders

Objectives

To evaluate the correlations between temporomandibular joint (TMJ) pain and both conventional and gadolinium-enhanced magnetic resonance (MR) imaging characteristics in patients with temporomandibular disorders (TMDs).

Methods

T1-weighted, T2-weighted, and fat-suppressed contrast-enhanced T1-weighted MR imaging were performed in 80 TMD patients with the main complaint of TMJ pain. A kappa statistical analysis was performed to calculate the interobserver agreement between two of three radiologists. The relationships between TMJ pain and various MR findings were analyzed by multiple comparison test, Spearman’s rank correlation test, Chi-square test, Student’s t test, and multivariate logistic regression analysis.

Results

Significant correlations were observed between anterior disk displacement without reduction, joint effusion, and TMJ pain (p < 0.01). The degree of contrast enhancement of the posterior disk attachment was correlated with the severity of TMJ pain, especially spontaneous pain (r = 0.725, p < 0.01), while no correlation was observed in the masticatory muscle pain group. The correlation tended to be higher in the latero-central portions than in the medial portion of the mandibular condyle, although no significant difference was seen.

Conclusions

It has been suggested that fat-suppressed contrast-enhanced MR imaging techniques facilitate better understanding of the sources of TMJ pain, but not masticatory muscle pain, and could reflect TMJ synovial inflammation. The severity of TMJ pain was closely correlated with the degree of contrast enhancement. The above-mentioned correlation had a tendency to be higher in the latero-central portions of the mandibular condyle.

     

Comparison of temporomandibular joint changes in Twin Block and Bionator appliance therapy: a magnetic resonance imaging study

Background

The objective of the present study was to evaluate and compare temporomandibular joint changes especially disk-condyle-fossa relationship following functional treatment of skeletal class II division 1 malocclusion using Twin Block and Bionator appliances.

Methods

The total sample consisted of 30 subjects (13 males and 17 females) with class II division 1 malocclusion having mandibular retrognathism, in the age group of 9 to 14 years. Two treatment groups, i.e., Twin Block and Bionator groups, were formed which comprised ten subjects each, while a group of ten subjects served as the control group. The treatment effects were evaluated using magnetic resonance imaging (MRI). For the treatment groups, pretreatment MRI with wax construction bite was taken. For all subjects, MRI images with corrected sagittal T1 images were recorded in a maximal intercuspation position at pretreatment (R1) and in an unstrained retruded position at the end of a 6-month observation period (R2).

Results

At the end of 6 months of treatment, the condyles occupied a more anterior position in the fossa to its pretreatment position, while the disk moved more posteriorly in relation to the condyle. The control group showed no changes in the condyle and disk position over a period of 6 months.

Conclusions

Although the treatment group showed consistent forward positioning of the condyle and backward movement of the disk, long-term MRI findings in these groups will further clarify the adaptations between the condyle fossa and articular disk.     

The prevalence,radiographic appearance,and characteristics of zygomatic air cell defects (ZACDs) in symptomatic temporomandibular joint disorder patients in North Indian population

Purpose

Although the incidence of zygomatic air cell defects (ZACDs) is significantly low in general population, still they pose as a risk factor during surgical procedures like eminectomies and eminoplasties because there is a risk of spread of infection intracranially. Furthermore, such procedures are more common in TMD patients. With this fact in mind, this study was designed to find out the prevalence, radiographic appearance, and characteristics of zygomatic air cell defects in diagnosed symptomatic temporomandibular joint disorder patients.

Method

The study comprised of evaluation of panoramic radiographs of 70 temporomandibular joint disorder (TMD) patients in the age range of 18–30 years selected on the basis of Research Diagnostic Criteria (RDC/TMD). The radiographs were evaluated regarding the presence, variations, and characteristics of ZACDs. Groups were compared by χ ² analysis.

Results

ZACDs were identified in 21 TMD subjects out of 70, giving an overall prevalence of 30 %. Out of 21 ZACDs, nine were in males (42.8 %) and 12 were in females (52.38 %). ZACDs were unilateral in ten TMD patients (47.61 %) and were bilateral in 11 patients (52.38 %).

Conclusion

It can be concluded that the number of ZACDs is surprisingly more in diagnosed TMD patients. This strengthens the need for thorough preoperative imaging evaluation of ZACDs in such patients. Further longitudinal studies are required to find out the long-term effect of ZACDs on symptomatic as well as non-symptomatic TMD subjects. This may prove helpful to appreciate that whether ZACDs have any role in the development TMDs and vice versa. As with many TMD studies, caution should be exercised in interpreting these results until further studies have been carried out on this topic. Ideally, some prospective randomised evaluations with “hard” evidence of the diagnosis with MRI support.     

Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals

Objective

We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT).

Methods

Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints.

Results

The eminence inclination (P?<?0.05), eminence height (P?<?0.0001), mediolateral width of condyle (P?<?0.0001), and anterior joint space (P?<?0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P?<?0.0001), ratio of anterior joint space to posterior joint space (P?<?0.001), posterior joint space (P?<?0.05), eminence inclination (P?<?0.05), eminence height (P?<?0.05), condyle shape (P?<?0.0001), and fossa shape (P?<?0.05).

Conclusions

The present analyses suggest that a steeper articular eminence inclination may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.

     

Clinical significance of T2 mapping MRI for the evaluation of masseter muscle pain in patients with temporomandibular joint disorders

Objectives

Masticatory muscle pain is one of the typical symptoms of temporomandibular joint disorders (TMD). T2 mapping (distribution of T2 values) is a notable MRI technique for evaluating water contents in tissues. We investigated the clinical significance of T2 mapping for the evaluation of masticator muscle conditions by comparing the difference in the T2 values between the painful and pain-free sides of the masseter muscle in patients with TMD.

Methods

Seventy-three patients clinically diagnosed with TMD were enrolled in this study. We divided the patients into two groups: a unilateral pain group (patients with unilateral masseter muscle pain) and a painless group (patients without muscle pain). There were 29 patients in the unilateral pain group and 44 patients in the painless group. We compared the difference in the mean T2 values between the painful and pain-free sides of the masseter muscle in the unilateral pain group and between the right and left sides in the painless group.

Results

The mean T2 values of the masseter muscle on the painful side were significantly higher than those on the pain-free side in the unilateral muscle pain group (p < 0.01). In the painless group, there was no significant difference in the mean T2 values between the right and left sides.

Conclusions

It is suggested that T2 mapping is a promising method for evaluating masseter muscle pain caused by edematous change related to TMD through monitoring of the T2 values.     

Dislocation of the mandibular condyle into the middle cranial fossa: a case report

Introduction

A 32-year-old woman was admitted to our hospital following a motor vehicle accident. Her chief complaint was severe limited mouth opening and unilateral open bite on the left.

Methods

Axial and coronal CT scans showed penetration of right condyle into the middle cranium through the fractured roof of glenoid fossa. A craniotomy exactly above the glenoid fossa was done.

Results

The condyle was reduced and the glenoid fossa was reconstructed.

Conclusion

On postoperative follow-up at 6 months, the patient had no complaint, but there was a small deviation to the affected side on opening.     

Electronic central bearing point as registration method in individuals with and without temporomandibular disorders

Objectives

The aim of this study was to examine different central bearing point methods in patients with and without temporomandibular disorders (TMD) by an experienced and unexperienced examiner.

Material and methods

The 20 fully dentulous subjects were screened for TMD based on the Research Diagnostic Criteria for TMD and distinguished into functional impaired and functional healthy groups. The mandibular relationship was recorded by an electronic central bearing tracing device (IPR-System, IPR GmbH, Oldenburg, Germany) with an integrated pressure sensor. Three bite registration methods were performed using this device: initial neuromuscular position, final neuromuscular position after dynamic sequences with the intraoral pin (=neuromuscular deprogramming), and centric relation guided manually by an experienced and an unexperienced examiner.

Results

The neuromuscular positions before and after neuromuscular deprogramming were not significantly different (paired t test as a group comparison test: transverse: p = 0.369; sagittal: p = 0.486). Both positions were significantly anterior in comparison to the manually guided centric relation (paired t test as a group comparison test: p < 0.0001). The neuromuscular positions before and after deprogramming tend to have high scattering values.

Conclusion

By means of the central bearing point method, the manually guided centric relation is the one which is sufficiently reproducible. It seems doubtful to take the significant anterior neuromuscular position for a definite reconstruction.

Clinical relevance

Using the central bearing point method, the manually guided centric relation should be preferred, whereas the neuromuscular position should not be used for definite reconstructions.

     

Analysis of trabecular bone using site-specific fractal values calculated from cone beam CT images

Objective

The purpose of the study was to explore the use of cone beam CT (CBCT) images to calculate fractal values of trabecular bone.

Materials and methods

Seventy-nine CBCT scans were used. Seven sites were selected from each scan. These sites were: coronal views of the (1) right and (2) left side of the mandible; coronal views of the (3) right and (4) left maxilla; axially corrected coronal views of the (5) right and (6) left condylar heads through the largest width, and (7) a sagittal section through the second cervical vertebral (C2) body. Fractal values were calculated from a total of 553 images using the box-counting method. These values were categorized and analyzed for site- and gender-specific differences.

Result

Fractal values decreased in most of the sites with increasing age. Values in males were generally higher than those in females. Values did not change significantly from right side to left side of the jaw. However, values from the mandible, maxilla, condyle and C2 vertebrae differed significantly from each other, suggesting a site-specific nature of the fractal value (p < 0.001). The lowest and highest fractal values were in the mandible and C2 vertebrae, respectively (1.313 and 1.536, respectively).

Conclusion

Fractal values can detect differences in the trabecular bone morphology in different parts of the jaw. Fractal values can potentially be used for objective analysis of the trabecular bone using CBCT images.     

Internal derangement in the temporomandibular joint of juveniles with clinical signs of TMD

Aim

The aim of this study was to investigate possible correlation of specific skeletal or dental class in children and adolescents with clinical signs of temporomandibular dysfunction (TMD) with the severity of internal derangement (ID) of the temporomandibular joint.

Materials and methods

Based on MRI images, the ID of 232 juvenile temporomandibular joints in 116 patients were retrospectively recorded. The distribution of the ID stages within the skeletal and dental classes was compared by means of the χ ² test.

Results

Excluding the comparison between skeletal Class I (S I) and skeletal Class II (S II; p < 0.05), no statistically significant differences in the distribution of the ID stages were found between the skeletal classes (p > 0.05). No statistically significant differences were found when comparing the distribution of the ID stages between the dental classes (p > 0.05).

Conclusion

According to these findings, there is no skeletal or dental class that is related to higher degrees of internal derangement in the TMJs of children and adolescents presenting clinical signs of TMD. Therefore, it is not possible to draw conclusions about the severity of the ID in relation to the dental and skeletal class in symptomatic juvenile TMJs.

     

Assessment of cervical spine postural disorders in patients with temporomandibular dysfunction: a radiographic evaluation

Objectives

This study aimed to assess the impact of abnormal head and neck posture on development of temporomandibular disorders (TMD) and to evaluate the possible correlation between cervical spine postural disorders and TMD by measuring craniocervical angles and distances in cervical spine radiographs of individuals with and without symptoms of temporomandibular joint dysfunction.

Methods

Forty-six subjects aged 20–50 years were selected from the outpatient department of M.S. Ramaiah Dental College and divided into TMD and control groups with 23 subjects per group. The patients were subjected to clinical and radiographic evaluations. TMD diagnosis was based on clinical criteria in the Research Diagnostic Criteria for TMD (RDC/TMD). Radiographic evaluation comprised intraobserver and interobserver analyses of lateral cervical spine radiographs with measurements of three angles and two distances in the craniocervical region.

Results

Diagnosis of myofascial pain without limited mouth opening (n = 12) was the most frequent TMD diagnosis according to RDC/TMD. Radiographic evaluation showed that only atlas plane angle (APA) (p = 0.002) and anterior translation distance (ATD; Tz C₂–C₇) (p < 0.001) showed significant differences between the TMD group (APA: 20.96 ± 7.94°; ATD: 11.04 ± 5.270 mm) and control group (APA: 28.17 ± 10.395°, ATD: 5.70 ± 3.535 mm). Significant correlations were observed for the parameters between the observers (p < 0.05).

Conclusions

The present results suggest that head and body posture could be related to the initial onset, development, and perpetuation of TMD and that TMD patients have a tendency to exhibit cervical spine hyperlordosis.     

MR-Volumetrie der Zunge zur Abschätzung der individuellen Zungengröße

Aim

The purpose of this study was to determine the volume of the tongue using MRI. The correlation of the individual volume of the tongue and the size of the oral cavity was to be investigated.

Material and methods

To analyze the tongue volume we combined coronal and sagittal data acquisition, which divided the tongue virtually into two lateral and one medial part. This procedure helped to decrease artefacts by partial volume effect. In 20 probands (m/f 7/13, average age of 36.3 years) the volume of the tongue was determined. Imaging protocol: Magnetom 63 SP (Siemens, Erlangen), T1-weighted sequences (TR/TE 500 ms/10 ms), slice thickness 5 mm, matrix 256×256, FOV 250 mm.

Results

There was a significant linear regression between the tongue volume and height of the mouth cavity. This correlation can be used to calculate the normal volume of a patient’s tongue.

Discussion

Volumetry of the tongue can be carried out by means of MRI without application of injurious X-rays. It can be employed before as well as after tongue reduction surgeries for therapy control. The individual ideal tongue volume can be determined easily by determination of the height of the oral cavity.     

Biochemical analysis of the articular disc of the temporomandibular joint with magnetic resonance T2 mapping: a feasibility study

Objectives

Symptoms of temporomandibular joint (TMJ) dysfunction can seriously compromise patients' quality of life. The aim of our study was to use magnetic resonance imaging (MRI) T2 mapping of the articular disc to determine whether T2 mapping of the TMJ disc is feasible in routine clinical imaging and to assess the normal T2 relaxation time distribution within the TMJ.

Methods

Included were ten asymptomatic volunteers without pain, any mouth-opening limitations, or any clicking phenomena. MR imaging was performed on a 3-T MR scanner using a flexible, dedicated, eight-channel multielement coil. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually.

Results

The mean values for ROIs ranged between 22.4 and 28.8 ms, and the mean for all ROIs was 26.0?±?5.0 ms. Intraclass correlation (ICC) for interobserver variability was 0.698, and ICC for intraobserver variability was 0.861. There was no statistically significant difference between raters (p?=?0.091) or sides (p?=?0.810).

Conclusion

The T2 mapping technique enables ultrastructural analysis of the composition of TMJ disc. This biochemical technique is feasible in vivo, as shown in our study, when a high-field (3 T) MR and a dedicated TMJ coil are used.

Clinical relevance

T2 mapping as a biochemical technique, together with morphological MRI, may help to gain more insights into the physiology and into the pathophysiology of the articular disc in the TMJ noninvasively and in vivo.     

Unilateral bony ankylosis of the temporomandibular joint in a case of ankylosing spondylitis

Background

Ankylosing spondylitis (AS) is a chronic inflammatory disease with multiple articular and para-articular involvement that has a predilection for the axial skeleton. In spite of its high prevalence, ankylosis secondary to AS is a rare condition.

Case report

A 31-year-old male diagnosed with AS was referred for computed tomography (CT) of the temporomandibular joint (TMJ) due to severe mouth opening limitation. The patient had a 16-year medical history of AS and sought assistance due to TMJ pain and incapacity to open his mouth.

Results

Previous bony scintigraphy revealed involvement of the spine, sacroiliac joints, right knee, and left TMJ. Magnetic resonance imaging revealed erosion of the left condyle and posterior slope of the articular eminence, and a mass of heterogeneous signal intensity between these structures. The left condyle also presented sclerosis/edema of the bone marrow and the disk could not be identified. Sagittal and coronal CT images showed moderate alterations of the TMJ on the right side. On the left side, the images displayed markedly eroded condyle and mandibular fossa, and a bony mass resulting in ankylosis of the osseous components of the joint.

Conclusion

TMJ ankylosis in AS patients is rare and very few reports have presented imaging features of the condition through advanced diagnostic techniques.     

Insufficient diagnostic accuracy of a single-item questionnaire to detect psychosocial distress in temporomandibular disorder patients

Objectives

Psychosocial assessment needs to be integrated into the diagnosis of chronic pain conditions; however, it is not clear how this assessment should be performed with minimal patient and health care provider burden. The aim of this study was to assess the diagnostic accuracy of a single-item questionnaire to detect psychosocial distress in temporomandibular disorder (TMD) patients.

Methods

Presence of psychosocial distress was measured in 126 TMD patients using Research Diagnostic Criteria for TMD Axis II measures (depression, somatization, dysfunctional chronic pain). A newly developed single-item questionnaire served as a test to detect psychosocial distress. The association between the presence of distress and test results was analyzed using generalized linear models (GLM). Diagnostic accuracy of the one-item test was assessed.

Results

The GLM revealed a statistically significant association between the presence of psychosocial distress and a positive test result (p?<?0.001). Psychosocially distressed patients were 70 % more likely to indicate psychosocial distress in the single-item questionnaire than patients without distress. However, diagnostic test accuracy of the single-item questionnaire was low (sensitivity 73.0 %, specificity 55.7 %). The resulting positive likelihood ratio (1.65) indicated that the single-item test is an inadequate measure for detecting psychosocial distress.

Conclusions

The single-item questionnaire was not sufficiently accurate for detecting TMD patients’ psychosocial distress and may therefore not be useful as an assessment tool for the various dimensions of psychosocial distress in TMD patients.

Clinical relevance

Health care providers should not trust in TMD patients’ responses to a single question regarding psychosocial distress. Nevertheless, this questionnaire may constitute a first step into a more profound patient–provider communication on psychological issues relevant to TMD.     

Correlation between direction and severity of temporomandibular joint disc displacement and reduction ability during mouth opening

The most common temporomandibular joint (TMJ) internal derangement is an abnormal relationship of the disc with respect to the mandibular condyle, articular eminence and glenoid fossa‐disc displacement. The aim of our study was to analyse the correlation between partial/complete disc displacement in the intercuspal position (IP) and its reduction in the open‐mouth position (OMP) in both oblique sagittal and coronal planes on magnetic resonance imaging (MRI) in patients with temporomandibular disorders. Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to the RDC/TMD criteria (148 women, 43 men; aged 14‐60 years). The disc position was evaluated on all oblique sagittal and coronal images in the IP and the OMP. Univariate logistic regression analysis showed that the severity of disc displacement in the sagittal plane is a statistically significant predictor of reduction ability during mouth opening (B = 3.118; P < .001). Moreover, the severity of disc displacement in both planes is also a significant predictor of disc reduction in OMP (B = 2.200; P < .05). In conclusion, reduction ability during mouth opening is associated with the severity of disc displacement in IP, in both sagittal and coronal planes. Multisection analysis of all MR images allows distinguishing the correct disc position from disc displacement and can improve the ability to distinguish between various stages of TMJ internal derangement.     

The use of cone beam computed tomography to predetermine root canal lengths in molar teeth: a comparison between two-dimensional and three-dimensional measurements

Objectives

The aim of this study was to evaluate the accuracy of two-dimensional (2D) and three-dimensional (3D) root canal length measurements in molar teeth using cone beam computed tomography (CBCT).

Materials and methods

Root canal lengths of twenty molar teeth were measured with two different CBCT approaches. After adjusting the CBCT images, 2D measurements were performed within the sagittal plane between the apical foramen and the coronal reference (cusp). The 3D approach measured centrically in axial planes. A linear mixed model with random intercepts was fitted to compare differences between methods (2D and 3D). The correlation between CBCT measurements and the actual root canal length was evaluated using the Pearson correlation coefficient.

Results

Differences between 3D measurements and the actual root canal lengths were significantly smaller compared to the 2D approach (p?<?0.001). Mean differences were 0.32 and 0.58 mm, respectively. A high correlation was found between the actual root canal length and 3D measurements (Pearson correlation coefficient?=?0.97). Compared to the actual root canal length, 80 % of the 3D measurements were within the limits of ±0.5 mm.

Conclusions

3D measurements of root canals in molar teeth are more accurate than simple 2D measurements and show a high correlation to the actual lengths.

Clinical relevance

In cases where a CBCT is already available, root canal lengths in molar teeth can be accurately predetermined using a standardized 3D approach.     

Time-course change in temporomandibular joint space after advancement and setback mandibular osteotomy with Le Fort I osteotomy

Purpose

The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy.

The randomized shortened dental arch study: temporomandibular disorder pain

Objectives

The aim of this multi-center, randomized controlled trial was to assess the impact of missing posterior support on the risk for temporomandibular disorder (TMD) pain by comparing patients with either shortened dental arches (SDA) or molar replacement by removable dental prostheses (RDP).

Methods

A sample of 215 patients with bilateral molar loss in at least one jaw was consecutively recruited in 14 prosthodontic departments of dental schools in Germany. Of the initial sample, 152 patients (mean age: 59.7 years; 53.9 % female) received randomly allocated interventions (SDA: n?=?71; RDP: n?=?81). Presence of TMD pain was assessed using patients’ self-reports and was verified by physical examination and by pain intensity, as the mean of current pain, worst pain, and average pain in the last 6 months, with 10-point ordinal rating scales. Assessments were performed before treatment and at follow-ups until 60 months after treatment. Impact of interventions on TMD risk and pain intensity was computed by applying logistic and linear random-intercept models.

Results

Tooth replacement (RDP) did not significantly change the risk for self-reported (odds ratio [OR]: 1.1; confidence interval [CI]: 0.4 to 3.4) or clinically verified (OR: 0.7; CI: 0.1 to 4.3) TMD pain compared to no tooth replacement (SDA). Mean characteristic pain intensity was virtually identical in both groups (Coeff: 0.01; CI: ?0.30 to 0.32).

Conclusion

Retaining or preservation of an SDA is not a major risk factor for TMD pain over the course of 5 years when compared to molar replacement with RPDs.

Clinical relevance

Seemingly, missing molars do not have to be replaced in order to prevent TMD pain.     

Autogeneous coronoid process as free graft for reconstruction of mandibular condyle in patients with temporomandibular ankylosis

Objective

This study was conducted to determine the efficacy of using the autogeneous coronoid process as free graft for reconstruction of mandibular condyle and to achieve structural, functional, as well as esthetic rehabilitation of patients with temporomandibular joint (TMJ) ankylosis.

Materials and Methods

This article presents the clinical results of an evaluation of ten cases of TMJ ankylosis treated by using autogeneous coronoid process as free graft for reconstruction of mandibular condyle after resection of ankylotic mass.

Results

Satisfactory mouth opening were obtained in all ten cases. No patient showed signs of re-ankylosis at 12 months follow-up. Preoperative mouth opening ranged from 0 to 15 mm with mean being 4.8 mm. As a result of successful procedure, the immediate postoperative mouth opening increased ranging from 24 to 31 mm (mean, 26.5 mm). Follow up of patients at the first and 12th month showed good results with increase in mouth opening from a range of 24 to 31 mm (mean, 27.8 mm ) to 26 to 36 mm (mean, 33.13 mm).

Conclusion

The results of this study suggest that the autogeneous coronoid process as free graft is a suitable graft material for reconstruction of mandibular condyle after resection of ankylotic mass.