Management of temporomandibular joint ankylosis in Yemeni children by metatarsal bone grafts

This study aimed to evaluate temporomandibular joint reconstruction in Yemeni children with metatarsal bone graft after release of ankylosis. Methodology: Ten patients ?12 years of age, comprising eight unilateral and two bilaterally TMJ ankylosis, were selected for this study. These patients underwent reconstruction with 10 non-vascularized metatarsal grafts. The reconstructed joints were then followed for an average of 1 year. Measures of opening, symmetry, and clinical symptoms relating to the reconstructed joints were assessed. Results: Mean pre-operative interincisal aperture was 8.2mm, and immediate post-operative aperture 23.4mm. At the end of the follow-up period, acceptable results were achieved in 8 out of 10 cases, with adequate mouth opening of 35.6mm in 8 out of 10 patients and overall interincisal aperture of 30.3mm. Re-ankylosis occurred in two bilaterallytreated patients at the end of follow-up. Subjectively, 80% of the patients rated their function as satisfactory and were able to occlude and masticate without any difficulty

Management of temporomandibular joint ankylosis in Yemeni children by metatarsal bone grafts.

Aim: This study aimed to evaluate temporomandibular joint reconstruction in Yemeni children with metatarsal bone graft after release of ankylosis. Methodology: Ten patients ≤12 years of age, comprising eight unilateral and two  bilaterally TMJ ankylosis, were selected for this study. These patients underwent reconstruction with 10 non-vascularized metatarsal grafts. The reconstructed joints were then followed for an average of 1 year. Measures of opening, symmetry, and clinical symptoms relating to the reconstructed joints were assessed. Results: Mean pre-operative interincisal aperture was 8.2mm, and immediate post-operative aperture 23.4mm. At the end of the follow-up period, acceptable results were achieved in 8 out of 10 cases, with adequate mouth opening of 35.6mm in 8 out of 10 patients and overall interincisal aperture of 30.3mm. Re-ankylosis occurred in two bilaterally-treated patients at the end of follow-up. Subjectively, 80% of the patients rated their function as satisfactory and were able to occlude and masticate without any difficulty. Conclusion: Reconstruction of TMJ after release of ankylosis utilizing metatarsal bone graft shows a satisfactory interincisal aperture in 80% of patients

Management of temporomandibular joint ankylosis in Yemeni children by metatarsal bone grafts.

Aim: This study aimed to evaluate temporomandibular joint reconstruction in Yemeni children with metatarsal bone graft after release of ankylosis. Methodology: Ten patients ≤12 years of age, comprising eight unilateral and two  bilaterally TMJ ankylosis, were selected for this study. These patients underwent reconstruction with 10 non-vascularized metatarsal grafts. The reconstructed joints were then followed for an average of 1 year. Measures of opening, symmetry, and clinical symptoms relating to the reconstructed joints were assessed. Results: Mean pre-operative interincisal aperture was 8.2mm, and immediate post-operative aperture 23.4mm. At the end of the follow-up period, acceptable results were achieved in 8 out of 10 cases, with adequate mouth opening of 35.6mm in 8 out of 10 patients and overall interincisal aperture of 30.3mm. Re-ankylosis occurred in two bilaterally-treated patients at the end of follow-up. Subjectively, 80% of the patients rated their function as satisfactory and were able to occlude and masticate without any difficulty. Conclusion: Reconstruction of TMJ after release of ankylosis utilizing metatarsal bone graft shows a satisfactory interincisal aperture in 80% of patients

Conventional versus Modified Preauricular Incision Approaches to the Management of Temporomandibular Joint Ankylosis in Sana’a City, Yemen: A Comparative Clinical Study

Objective: To compare between the conventional and modified preauricular incision approaches to the management of temporomandibular joint (TMJ) ankylosis among Yemeni patients in Sana’a city, Yemen. Methods: This comparative clinical study recruited ten patients (7 males and 3 females; age range: 6–35 years) with true fully or partially bony or fibrous TMJ ankylosis. These patients were admitted to and followed up in the Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Science and Technology Hospital in Sana’a in the period from May 2013 to February 2016. Five patients with condylar capsule ankylosis were subjected to the conventional preauricular approach, while the other five cases with ankylosis that extends beyond the condylar capsule and reaches the zygomatic arch were subjected to the modified preauricular approach. Both approaches were evaluated and compared for the time required, intra- and post-operative complications and aesthetic results. Results: The mean times required to carry out the operations were 4.45 and 3.20 hours for conventional and modified preauricular approaches, respectively.Facial nerve injury was present in two patients undergoing the conventional preauricular approach, but this reversed to normal after four to five months. Patient of both groups experienced no facial paralysis or post-operative auriculotemporal syndrome. Intra-operative bleeding was mild to moderate among the patients of both approaches, and none of the patients required blood transfusion intra- or post-operatively. Major blood vessels were injured in three cases undergoing the conventional preauricular approach. All patients subjected to both approaches showed satisfactory aesthetic end results. Conclusions: Conventional and modified preauricular approaches provide excellent accessibility and visibility to the surgical field during the management of TMJ ankylosis among Yemeni patients, with the latter being slightly superior. In addition, the modified preauricular approach is associated with fewer complications, absence of facial nerve injury and reduced surgical time compared to the conventional approach