SU1643001A1 - Method of treatment maxillotemporal joint anchylosis - Google Patents

Abstract

The invention relates to medicine, namely to surgical dentistry. The aim of the invention is to restore the function of the newly formed joint. This goal is ensured by the fact that the grafting is performed with a graft from the iliac scallop with the muscle tissue adjacent to its anterior-superior spine and the epidermalized skin. A positive effect is evaluated by an improvement in functional results.

Description

The invention relates to medicine, namely to surgical dentistry.

The purpose of the invention is to restore the function of the newly formed joint.

The method is carried out as follows.

Under intubation anesthesia, the submandibular access exposes the branch and the area of the ankylosed mandibular joint. The osteotomy of the branch and mandible is performed as close as possible to the natural location of the joint, the conglomerate is removed, and an artificial joint arcuate is formed on the remaining part of the joint. of the mouth, a maxillary splint is placed on the teeth, the lower jaw is placed in an orthognathic bite and fixed with maxillary throat.

Under the same anesthesia, two semi-oval cuts left a pad of pre-epidermized skin (3x3 cm), subcutaneous tissue and muscle tissue with a periosteum at the end of the anterior upper spine of the iliac crest. With the help of a circular disk, an autograft of the required size is re-sawn. The wound is sutured in layers, drained by a rubber graduate, and an aseptic dressing is placed. The soft tissues of the newly formed articular head are fixed with two mylar sutures with the zygomatic process of the temporal bone. The graft skin is fixed to the mandible branch with two wire sutures. The tissues are laid in place, the wound is sutured in layers, and a rubber graduate is left to prevent hematomas. Complete the operation by applying an aseptic dressing.

Example. Patient PA 17 years, date of entry is 17.12.86. disease number 3232/1967.

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Diagnosis: bone ankylosis of the left temporomandibular joint.

Complaints: deformity of the face in the area of the left temporomandibular joint, restriction of opening of the mouth, unpleasant smell from the mouth, violation of the act of chewing, swallowing, speech from the anamnesis, in childhood suffered a hematogenous osteomyelitis of the left condylar process. The patient is irritable, withdrawn. Locally: asymmetry of the face due to deformation in the region of the left temporomandibular joint. The movement of the articular head on the left is not detected. The opening of the mouth is sharply limited to 0.5 cm. There are no lateral and sagittal movements of the lower jaw. In the oral cavity, the occurrence of gingivitis, the deposition of a large number of tartar.

Radiographic examination of the lower jaw: a solid bone mass that occupies the entire joint and coronary process, to the lower jaw on the left. The joint gap is not traced. 12/30/86 under an incubation anesthesia, an operation was performed on an osteotomy of the mandible branch on the left with the removal of a bone conglomerate and an autograft transplant. Under the same anesthesia with two semi-oval cuts, leaving a platform of epidermized skin (3x3 cm), subcutaneous tissue, muscle tissue with a periosteum at the end of the front upper spine of the scallop

and

the ilium, the scallop is exposed and the autograft is cut by a round disc according to the size of the mandible defect. Complex mck-1: from the tissues of the graft is fixed to the cheekbone process of the temporal bone and an artificially shaped weave is placed. On the 7th day you are stitching. Wound survival by primary tension. Naza. We miogimnastika,

10 mechanotherapy, physiotherapy exercises. As a result of the operation, movements in the left temporomandibular joint were fully restored, the mandibular deformity was eliminated. Observed over the course of 15 yes. This technique was operated on 3 patients.

The method allows to obtain a stable and full function of the newly formed joint, to prevent the recurrence of ankylosis,

20 to eliminate the deformation of the lower jaw.

Claims (1)

The invention of the method of treating ankylosis of the temporomandibular joint by osteotomy with 25 subsequent plasty with allograft, characterized in that, in order to restore the function of the new joint, the plasty is performed with a graft from the iliac bone 30 with adjacent to its anterior superior muscle of the muscular tissue. epidermized skin.