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首页> 外文期刊>Maxillofacial Plastic and Reconstructive Surgery >Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients
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Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

机译：颞下颌关节强直患者使用关节间夹板进行主动张口运动的间隙关节置换术

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Abstract BackgroundTemporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis.MethodsA total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period.ResultsAll patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS’s guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35?mm more than 6?years after surgery.ConclusionsComplete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.
机译：摘要背景儿童时期的颞下颌关节强直可能会导致生长发育和面部不对称，并在进食和睡眠呼吸方面造成严重困难。这项研究的目的是描述一种咬合夹板（IOS）在主动张口运动中治疗TMJ关节强直的效果。方法2008年至2010年共纳入9例患者，共13例TMJ关节强直，其中男5例，女4例。五例患者表现为单侧强直，而五例患者表现为双侧症状。在不进行介入移植的情况下，采用间隙关节置换术进行强直性大规模切除术并进行冠状动脉切除术，纤维化疤痕松解术和糖突韧带钙化切除术，并在平均6.6年的随访期内评估所有患者的最大张口（MMO）。自手术当天起，根据IOS，对患者进行了术后张口运动，该操作基于手术期间的印象。所有患者均能按照IOS的引导平面和撞击方式移动下颌骨，并获得令人满意的结果，其中MMO在术后6年以上改善了35？mm。结论：完成并充分切除了强直性骨块和术后积极的张口练习对TMJ强直症的治疗至关重要。此外，使用IOS可以实现更舒适的张口引导和交叉指指，并且可以建议在刚切除的con突头和颞窝之间的间隙中重新组织化纤维化。

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