Tratamento da anquilose da articulação tempero-mandibular : estudo retrospectivo

Abstract

Temporomandibular joint ankylosis can be defined as impediment of excursion normal of the mandible for involvement of joint or its adjacencies. The ankylosis can occur by sequelae of some pathologies, however it’s as main causal factors are trauma and infection. The diagnosis is made on the basis of clinical examinations and images. The ankylosis compromises the condilar’s growth center, evolution to face deformities as more serious as the more early if it has installed in infancy. There isn’t a consensus, how much the existence of only one treatment standard for the correction of the ankylosis. In one review of literature, the current modalities of treatment are the Gap, the interposition arthroplasty and the excision and reconstruction of the joint. In a comparative study about two modalities of arthroplasty, the preference falls again for the interposicional, through to retail of muscle and/or temporal fascial. In the reconstructions of the TJM with autogenous graft, the preference fits to graft of chondral rib, for its potential of growth and remodeling in youthful patients, and for the low rate of morbidity in the adult patients. The sample in this retrospective study was obtained from the records of the teaching hospital, patients who had to undergo ankylosis treatment by alloplastic or autogenous graft between March 1992 and July 2008. Pre- and post-operative assessment included a throughout history and physical examination to determine the cause of ankylosis, the maximum mouth opening, etiology and type of ankylosis, recurrence rate and presence of facial nerve paralysis. The mean maximum mouth opening in the pre-operative period was 5.37 mm (0.0 mm to 13 mm) and in the post-operative period it was of 32.06mm (12 mm to 45mm), there was facial nerve paralysis and there was recurrence in just one case. The joint reconstruction with alloplastic or autogenous grafts for the ankylosis treatment proved to be efficient in relation to the post-operative maximum mouth opening, recurrence and joint function.