| Summary: | A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry in the department of Maxillo-Facial and Oral Surgery, 2018 === Introduction: Temporomandibular joint (TMJ) ankylosis may be defined as the fusion of
joint surfaces with bony or fibrous tissue which causes limitations on the functional activities
of the oral cavity. Surgical treatment includes gap arthroplasty (GA), interpositional
Arthroplasty (IA) and joint reconstruction using costochondral graft (CCG), iliac crest,
clavicular, fibular, and metatarsal or alloplastic prosthesis and distraction osteogenesis.
Aim and objectives: The aim of this retrospective study was to compare outcomes of GA
with CCG. The objectives were to identify factors that are associated with surgical outcomes,
to identify the age group that is commonly affected and to compare the mean maximum
interincisal opening (MIO) in two surgical procedures.
Materials and Methods: This retrospective study evaluated outcomes of 40 patients who
were treated with GA and CCG between February 2007 and December 2016. The data were
analysed and classified into pre-operative, intra-operative and post-operative stages. The
outcomes were evaluated by calculating an achieved MIO (final MIO – preoperative MIO),
and post-operative change in MIO (Op MIO - final MIO) and the final MIO, which refers to
the last recorded MIO.
Results: Forty patients met the criteria for this study, twenty-seven were males and thirteen
were females, the age range was 2 to 55 years. Trauma was the main cause of ankylosis with
(62%) (n=26), followed by congenital defects with (27.5%) (n=11) and infection with (7.5%)
(n=3). The mean of the final MIO of GA and with CCG was 30 mm (SD= 7.31) and 29.47
mm (SD= 6.79) respectively. The mean of A-MIO for GA and with CCG was 22.76 mm
(SD= 8.61) and 24.1 mm (SD= 7.16) respectively, while the Pop-MIO for GA and with CCG
was -3.85 mm (SD= 10.11) and -2.10 mm (SD= 7.49) respectively. The results showed no
statistically significant difference (P > 0.05) in the mean MIO between two groups under GA
v
and CCG. In addition, it showed no association between the complications, age, gender and
aetiology that were investigated by using logistic regression.
Conclusion: The findings of this study suggest that there is no difference in surgical
outcomes between GA and IA with CCG, and the most common age groups that was affected
was third stage 20-29 years (42.5%), with no association between factors and surgical
outcomes. === XL2018
|
|---|
