Retrospective analysis of a TMJ ankylosis protocol with a 9 year follow up
| Autor: | P. Nanda Kishore, Vikram Shetty, Anirudh Yadav, Adeeba Khanum, Hermann F. Sailer |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent medicine.medical_treatment Ankylosis Dentistry Arthroplasty Resection 03 medical and health sciences 0302 clinical medicine medicine Retrospective analysis Humans Statistical analysis Tmj ankylosis Patient compliance Physical Therapy Modalities Retrospective Studies Temporomandibular Joint business.industry Recovery of Function 030206 dentistry Temporomandibular Joint Disorders Temporomandibular joint medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Patient Compliance Female Surgery Bite block Oral Surgery business Follow-Up Studies |
| Zdroj: | Journal of Cranio-Maxillofacial Surgery. 47:1903-1912 |
| ISSN: | 1010-5182 |
| Popis: | Temporomandibular joint ankylosis (TMJa) is a debilitating condition that causes difficulty in mastication, speech and mouth opening. Its treatment poses surgical and rehabilitative challenges along with a high incidence of reankylosis. This study was designed to assess the long-term outcomes with a new two phase physiotherapy protocol following conservative resection of the ankylotic mass.143 patients who were treated for TMJa were initially recruited, among whom 98 were inducted into the study and retrospectively evaluated using clinical records and 3-dimensional computed tomography. All the patients underwent a minimal pre auricular incision and conservative interpositional gap arthroplasty with collagen membrane. This was followed by the new two phase physiotherapy protocol with the use of a bite block. The primary outcome measures were the maximum interincisal distance, vertical ramus height and complications. The patients were followed up at monthly intervals during the first year, quarterly intervals during the second year, and at intervals of 6 months during subsequent follow-up years. The mean follow up period was 6.38 ± 2.36 years after ankylotic release. Paired student t test was used for statistical analysis.The mean scores for mouth opening at T1, T2 and T3 were statistically significantly different at all intervals (p 0.0005). The mean scores for ramal length were statistically significantly different at T1 and T2 interval (p 0.0005) and insignificant at T2 and T3 interval. No reankylosis was observed in patients who followed the physiotherapy protocol.In the management of TMJa, the success of the conservative surgical technique with interpositional arthroplasty is less dependent on the longevity and rigidity of the interpositional material but more indebted to the patient compliance in following the proposed physiotherapy protocol. |
| Databáze: | OpenAIRE |
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