title: [Clinical application of transport distraction osteogenesis arthroplasty in the treatment of temporomandibular joint bony ankylosis].
abstract: OBJECTIVE
  To explore the clinical application of transport distraction osteogenesis arthroplasty (TDOAP) in the treatment of temporomandibular joint (TMJ) bony ankylosis.
  
  
  METHODS
  From December 1999 to December 2011, a total of 73 patients (89 sides of TMJ) underwent TDOAP were included. There were 39 males and 34 females with a mean age of 19.6 years (range: 3 - 60). Among them, 27 patients were recurrence cases and 30 cases were accompanied with micrognathia and obstructive sleep apnea-hypopnea syndrome (OSAHS). The mean preoperative degree of mouth opening was 6.6 mm (range: 1 - 20). After a release of ankylosis, a transport disc was performed and fixed to ramus with a distractor. Distraction began at Days 4 - 8 postoperation. The distraction rhythm and rate were 0.25 mm four times daily. Distraction stopped when planning distance was achieved. And a distractor was maintained in place for 3-6 months after completion of distraction and then removed. Active postoperative training of mouth opening was implemented.
  
  
  RESULTS
  The mean distance of distraction was 15.3 mm (range: 12 - 23). The range of mouth opening of 65 patients increased to normal and bone formation in gaps were perfect. The mean follow-up period was 44.8 months (range: 18 - 102). Eight cases were recurrent. And 1/37 over 15 years old and 7/36 under 15 years old had recurrence.
  
  
  CONCLUSIONS
  TDOAP is an effective treatment for TMJ ankylosis. A pediatric patient, especially recurrent, should be operated after adolescence to decrease recurrence. Micrognathia and OSAHS should be also considered during the treatment of ankylosis.
authors.affiliation: Department of Oral & Maxillofacial Surgery, Peking University, Beijing, China. chliang0719@sina.com
authors.forename: Cheng
authors.initials: C
authors.lastname: Liang
authors.forename: Xing
authors.initials: X
authors.lastname: Wang
authors.forename: Biao
authors.initials: B
authors.lastname: Yi
authors.forename: Zi-li
authors.initials: ZL
authors.lastname: Li
authors.forename: Xiao-xia
authors.initials: XX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000150:complications / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008844:Micrognathism / Q000150:complications; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000379:methods*; D012008:Recurrence; D020181:Sleep Apnea, Obstructive / Q000150:complications; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000601:surgery*; D014143:Traction; D055815:Young Adult