Journal of Dentistry of Tehran University of Medical Sciences 2018. 15(1):63-68.

A New Method of Treatment of Temporomandibular Joint Ankylosis with Osteodistraction Using the Sh-Device: A Case Report
Gholamreza Shirani, Mahnaz Arshad, Xaniar Mahmoudi

Abstract


This case report presents a 16-year-old boy with bilateral temporomandibular joint (TMJ) bony ankylosis due to trauma. The patient had undergone several unsuccessful therapeutic surgeries and was experiencing reduced mouth opening, difficulty in eating and speaking, poor oral hygiene, snoring, and depression. Bilateral gap arthroplasty and distraction osteogenesis (DO) were performed. After the surgery, we were able to move the osteodistractors forward and prevent the upward and backward movement of the proximal mandibular segment with the use of our custom-made Sh-device, which allowed bone growth and soft-tissue matching. The mandibular deficiency was treated, and the patient's sleep quality significantly improved after three months. The physical, orthodontic and speech therapies were continued. The facial asymmetry, difficulty in sleeping, eating and speaking, and low self-esteem were completely resolved. At the 8-year follow-up, the patient's condition was satisfactory. The Sh-device can be used as a contemporary treatment modality for TMJ ankylosis.


Keywords


Temporomandibular Ankylosis; Distraction Osteogenesis; Bone Lengthening; Tissue Expansion; Treatment Outcome

Full Text:

PDF

References


- Bello SA, Aluko Olokun B, Olaitan AA, Ajike SO. Aetiology and presentation of ankylosis of the temporomandibular joint: report of 23 cases from Abuja, Nigeria. Br J Oral Maxillofac Surg. 2012 Jan;50(1):80-4.

- Long X, Li X, Cheng Y, Yang X, Qin L, Qiao Y, et al. Preservation of disc for treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg. 2005 Jul;63(7):897-902.

- Sporniak-Tutak K, Janiszewska-Olszowska J, Kowalczyk R. Management of temporomandibular ankylosis--compromise or individualization--a literature review. Med Sci Monit. 2011 May;17(5):RA111-6.

- Vibhute PJ, Bhola N, Borle RM. TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement-A Case Report. Case Rep Dent. 2011 Sep;2011:187580.

- Felstead AM, Revington PJ. Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis. Int J Rheumatol. 2011 Jan;2011:854167.

- Shashikiran ND, Reddy SV, Patil R, Yavagal C. Management of temporo-mandibular joint ankylosis in growing children. J Indian Soc Pedod Prev Dent. 2005 Mar;23(1):35-7.

- Cistulli PA. Craniofacial abnormalities in obstructive sleep apnea: implications for treatment. Respirology. 1996 Sep;1(3):167-74.

- Braimah RO, Oladejo T, Olarinoye TO, Adetoye AO, Osho PO. A multidisciplinary approach to the management of temporomandibular joint ankylosis in a sickle-cell anemia patient in a resource-limited setting. Ann Maxillofac Surg. 2016 Jan-Jun;6(1):130-4.

- Natu SS, Ali I, Alam S, Giri KY, Agarwal A, Kulkarni VA. The biology of distraction osteogenesis for correction of mandibular and craniomaxillofacial defects: A review. Dent Res J (Isfahan). 2014 Jan;11(1):16-26.

- Andrade N, Gandhewar T, Kalra R. Development and evolution of distraction devices: Use of indigenous appliances for Distraction Osteogenesis-An overview. Ann Maxillofac Surg. 2011 Jan;1(1):58-65.

- Maheshwari S, Verma SK, Tariq M, Prabhat KC, Kumar S. Biomechanics and orthodontic treatment protocol in maxillofacial distraction osteogenesis. Natl J Maxillofac Surg. 2011 Jul;2(2):120-8.

- Giraddi GB, Arora K, Sai Anusha AJ. Distraction osteogenesis in the treatment of temporomandibular joint ankylosis with mandibular micrognathia. Ann Maxillofac Surg. 2016 Jan-Jun;6(1):68-74.

- Qudah MA, Qudeimat MA, Al-Maaita J. Treatment of TMJ ankylosis in Jordanian children - a comparison of two surgical techniques. J Craniomaxillofac Surg. 2005 Feb;33(1):30-6.

- Heggie AA, Kumar R, Shand JM. The role of distraction osteogenesis in the management of craniofacial syndromes. Ann Maxillofac Surg. 2013 Jan;3(1):4-10.

- Kiani MT, Bayat M, Ajami M, Beiranvand R, Mohammadi Golrang E, Kharazifard MJ. Functional outcomes of temporomandibular joint ankylosis treatments: A 10-year cohort study. Regen Reconstr Restor. 2016 Nov;1(1):20-24.

- Sharma A, Paeng JY, Yamada T, Kwon TG. Simultaneous gap arthroplasty and intraoral distraction and secondary contouring surgery for unilateral temporomandibular joint ankylosis. Maxillofac Plast Reconstr Surg. 2016 Dec;38(1):12.

- Li KK, Powell NB, Riley RW, Guilleminault C. Distraction osteogenesis in adult obstructive sleep apnea surgery: a preliminary report. J Oral Maxillofac Surg. 2002 Jan;60(1):6-10.


Refbacks

  • There are currently no refbacks.


Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.