Mandibular condylectomy with osteoarthrectomy with and without transfer of the temporalis muscle.
Twenty-two patients with chronic arthritis and ankylosis of the temporomandibular joint (TMJ) were treated by resection of the condyle with osteoarthrectomy and interposition with a temporalis muscle flap. We compared them with 14 patients who were treated by condylectomy and osteoarthrectomy alone. All patients were evaluated prospectively. Most patients had had a previous operation on the disc. Variables investigated before and after operation were pain during mandibular movements (using a visual analogue score (VAS) of 1-10) and impaired mandibular function such as chewing and biting off (also using a VAS of 1-10). Maximum interincisal opening was measured with a ruler. Both groups of patients showed significant improvements in all the variables evaluated. Using the predefined success criteria, both methods showed good success rates with few complications. The patients treated by interposition of the temporalis muscle tended to do better, but not significantly so. Both methods induced occlusal changes and some needed dental treatment postoperatively.
Division of Oral and Maxillofacial Surgery, Department of Dental Medicine, Karolinska Institutet/Karolinska University Hospital, Box 4064, S 141 04 Huddinge, Sweden. Anders.Holmlund@ki.se
Anders
A
Holmlund
Bodil
B
Lund
Carina Krüger
CK
Weiner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000844:Ankylosis / Q000601:surgery*; D001168:Arthritis / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods; D001732:Bite Force; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008335:Mandibular Condyle / Q000601:surgery*; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D010147:Pain Measurement; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D013701:Temporal Bone / Q000601:surgery; D013703:Temporal Muscle / Q000637:transplantation*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult