title: Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome.
abstract: This clinical and radiographic study investigated the use of transport distraction osteogenesis in unilateral temporomandibular joint (TMJ) ankylosis patients. Six patients aged between 4 and 8 years were selected for the study; the mean preoperative maximal inter-incisal opening (MIO) was 3.5mm without lateral and protrusive mandibular movements. The ankylotic mass along with the posterior border of the ascending ramus was exposed via 'lazy-S' incision. A gap arthroplasty was performed, followed by a 'reverse L' osteotomy on the posterior border of the ramus. In-house manufactured extraoral distraction devices were used for this prospective study. Follow-up clinical and radiographic evaluation was carried out for 13-27 months after completion of the activation period. After a mean follow-up of 19 months, the mean MIO was 29.1mm and the lateral and protrusive movements changed from none to slight. Cone beam computed tomography images of all patients showed remodelled neocondyle created by transport distraction osteogenesis with no statistically significant differences observed for average cancellous bone density, trabecular number, and trabecular spacing between the neocondyle of the operated side (test) and the condyle of the non-operated side (control). Neocondyle formation by transport distraction osteogenesis using the in-house distraction device is a promising treatment option for TMJ reconstruction in ankylosis patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Subharti University, Meerut, Uttar Pradesh, India. Electronic address: drbansalvishal@rediffmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Bansal
authors.affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Subharti University, Meerut, Uttar Pradesh, India.
authors.forename: S
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Subharti University, Meerut, Uttar Pradesh, India.
authors.forename: N
authors.initials: N
authors.lastname: Garg
authors.affiliation: Department of Oral and Maxillofacial Surgery, Subharti Dental College, Subharti University, Meerut, Uttar Pradesh, India.
authors.forename: P
authors.initials: P
authors.lastname: Dubey
mesh_terms: D000058:Accidental Falls; D000844:Ankylosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D013704:Temporomandibular Joint / Q000293:injuries; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: CBCT; TMJ reconstruction; ankylosis; distraction osteogenesis; in-house distractors; temporomandibular joint (TMJ)