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Comparison of arthrotomographic and magnetic resonance images of 50 temporomandibular joints with operative findings.

Arthrotomography and magnetic resonance imaging (MRI) were carried out on 50 temporomandibular joints (TMJs) in 48 patients who were being considered for surgery for clinically diagnosed internal derangement. The patients presented over a 4-year period with pain and dysfunction which had failed to respond to conservative management. Open surgery was carried out on all TMJs and operative findings compared with the results of imaging. The clinical diagnosis of internal derangement was confirmed in every case by imaging and at surgery. Arthrotomography over-diagnosed non-reducibility of an anteriorly displaced meniscus and perforation. MRI over-diagnosed non-reducibility to a lesser extent and under-diagnosed perforation. MRI demonstrated neither bony changes nor adhesions. Dynamic arthrotomography produced the best images of meniscal derangement in function and the pre-arthrogram tomograms were the best indicator of osseous abnormality. Arthrotomography was the preferred imaging technique.

Adolescent↗

Use of the titanium-coated hollow screw and reconstruction plate system in bridging of lower jaw defects.

Clinical results obtained with hollow titanium screws and reconstruction plates in the bridging of mandibular bone defects of 17 patients are described. Following implantation the newly forming bone establishes direct contact with the sprayed titanium surface of the screw and the underside of the plate and permeates the screw. The stability of anchorage therefore increases with the duration of implantation. The reconstruction system also allows salvaging of small fragments such as the condyloid process. The adjustable, individually shaped, mandibular condylar prosthesis permits precise restoration of articular guidance on the reconstructed side while preventing incorrect loading of the opposite joint. The clinical results confirm the recently published findings from animal studies.

Adult↗

Comparison of panoramic and standard radiographs for the diagnosis of mandibular fractures.

This study was undertaken to compare the panoramic radiograph with the standard hospital mandibular series for the diagnosis of mandibular fractures. Of the 88 fractures present in the patient population, 92% were recognized in the panoramic radiograph, while only 66% were detected in the hospital series. All fractures seen in the hospital series were also seen in the panoramic view. It was therefore concluded that the panoramic view is superior to the standard hospital series for the diagnosis of mandibular fractures.

Female↗

Open reduction of condylar fractions of the mandible in conjunction with repair of discal injury: a preliminary report.

Fractures of the condylar process of the mandible may require open reduction and internal fixation in some instances. In previous reports on the management of such cases, no discussion has focused on the associated soft tissue injuries of the temporomandibular joint. In this article, the authors review their experiences with open reduction of condylar fractures in conjunction with soft tissue reconstruction of the disc and associated structures.

Adult↗

Intraoral open reduction with rigid internal fixation of mandibular subcondylar fractures.

Open reduction of subcondylar fractures achieves precise anatomic alignment of bony fragments and may prevent the postoperative sequelae seen with some closed reductions. Using an extraoral approach, a fracture can be easily seen and manipulated. An intraoral approach avoids large facial scars, facial nerve injury, and allows visualization of the occlusion during the procedure. Cases for this technique should be carefully selected.

Bone Plates↗

Temporomandibular joint ankylosis: surgical treatment and long-term results.

The surgical treatment of 26 patients with ankylosis of the temporomandibular joint, as well as various methods and materials used for functional restoration are described. The significance of radical removal of the ankylotic bone, as well as the advantages of the interpositioning of the lyophilized cartilage, are emphasized.

Adolescent↗