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Órgano Ofical de la Facultad de Estomatología de la Benemérita Universidad Autónoma de Puebla

2017, Number 57

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Oral 2017; 18 (57)

Arthroplasty with silastic interposition for the treatment of bilateral temporomandibular ankylosis

Cárcamo-Idiáquez OA, Roa-Encarnación CM, Vivanco-Pérez I, Navarro-Zarate A, Anchecta-Castro DM, Macías-Rivera S

Language: Spanish
References: 35
Page: 1492-1496
PDF size: 342.43 Kb.


ABSTRACT

Introduction. The ankylosis of the temporomandibular joint (TMJ) is a pathological condition that causes limitation of the oral opening by the formation of bone or fibrous tissue between the joint components, this can occur unilaterally or bilaterally, its etiology in adults and children is mainly secondary to trauma and is thought to be caused by an episode of hemarthrosis. Presentation of the case. A 10-year-old male with a diagnosis of bilateral ATM ankylosis secondary to trauma, which was treated with arthroplasty and interposition of silastic plus bilateral coronoidectomy. After one year of follow-up, the patient remained asymptomatic with an oral opening of 21 mm. Currently under treatment by pediatric dentistry with good evolution and waiting to meet age to begin orthognathic surgery protocol. Discussion. The treatment of ATM ankylosis is surgical and its objective will be to obtain an oral opening that allows the patient an adequate masticatory, respiratory, speech function, as well as an adequate oral hygiene among others. The choice of treatment modality will depend on the severity, age and socioeconomic status of the patient; treatment options include simple arthroplasty, arthroplasty with interposition and joint reconstruction, all with variable results. Walker in 1958, was the first to describe the use of silastic in TMJ arthroplasties, the use of alloplastic material, prevents reanquilosis and preserves the vertical height of the mandibular branch, obtaining good results with lower cost and lower morbidity. Conclusion. The ankylosis of ATM in children is a complex problem, in this case it was decided to perform bilateral arthroplasty with interposition of silastic because of its low cost, lower morbidity and low recurrence rate, obtaining acceptable results to date.


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