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A clinical study on the management of chronic recurrent temporomandibular joint dislocation by modified eminoplasty

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Oral & Maxillofacial Surgery

Authors

El-Sharqawi, Abdel-Muez Muhammad

Accessioned

2018-08-26 05:48:00

Available

2018-08-26 05:48:00

type

M.D. Thesis

Abstract

Purpose: This study evaluates modified eminoplasty as an alternative augmentation technique to manage chronic recurrent dislocation (CRD) of temporomandibular joint (TMJ) both clinically and radiographically. Patients & Methods: Six CRD patients (2 males and 4 females) with a mean age of (32.5±5.36 years) were treated with bilateral modified eminoplasty. A seventh patient was excluded from this study due to postoperative antidepressant therapy. An oblique mediolateral osteotomy slanting upwards was cut in the articular eminence through a preauricular endaural approach. Two rectangular shaped bone wedges harvested from the chin through a vestibular approach were gently inserted and tapped into the osteotomized eminencia creating a green stick fracture without osteosynthesis for graft fixation. The excess bone was trimmed flush with the posterior slopes of both eminences. Maxillomandibular fixation was maintained posrtoperatively for a period of two weeks. Patients were followed-up clinically and radiographically using Cone Beam Computed Tomography for six months. Results: After six months, there was a total gain of (12.98 ± 4.19%) in the mean peak amplitude of the eminences. There was a net reduction of (25.29 ± 8.11 %), (28.93 ± 19.08 %) & (20.21 ± 14.27 %) in the maximum inter-incisal opening, protrusive and laterotrusive measurements respectively. There was no motor nerve deficit and neurosensory deficit of the mental and auriculotemporal nerves occurred only temporarily. Healing was uneventful with only mild postoperative pain and oedema. The extra-oral scars had satisfactory aesthetic results. Reccurence of dislocation occurred only in one TMJ for a couple of times and was self reducible without posing any further risks. Conclusion: This study proves the success of modified eminoplasty in managing CRD of the TMJ. It preserves its anatomical components providing free excursions without the risk of further dislocation and obviating the need for osteosynthesis hardware. It is a technique sensitive procedure that requires care and experience during splitting of the eminence and graft insertion to avoid complete fracture of the caudal aspect of the eminence. This was greatly aided by the specifically designed instrument (Moez Graft Tucker)

Issued

1 Jan 2011

DOI

http://dx.doi.org/10.21473/iknito-space/39895

Details

Type

Thesis

Created At

28 Jan 2023