temporomandibular joint ankylosis

  • 文章类型: Case Reports
    颞下颌关节强直(TMJ)是关节的病理状况。这种疾病表现为对TMJ运动完全失败的限制,通常在外伤或手术后或由于局部感染。这种情况可能会导致咀嚼困难,说话,嘴巴的结构,脸,或者下巴,并在很大程度上保持口腔卫生。计算机断层扫描(CT)扫描是评估TMJ骨解剖结构的最佳方法。本报告显示了TMJ强直的手术矫正。一名二十三岁的女性在医院就诊,显示严重的张口限制(9毫米)。关于调查,诊断为左TMJ强直。手术入路包括左侧牵引成骨,然后是剧烈的物理治疗。在TMJ强直患者中,恢复正常功能和下颌运动是困难的。该病例报告强调了物理疗法作为治疗TMJ强直的新兴辅助疗法的重要性。也有几种治疗方法用于提高患者的自尊和信心,包括言语治疗和心理咨询。
    Ankylosis of the temporomandibular joint (TMJ) is a pathological condition of the joint. The disease manifests as a limitation to total failure of movement of the TMJ, usually following trauma or surgery or due to local infection. The condition may result in difficulty masticating, speaking, structure of the mouth, face, or jaw, and maintaining oral hygiene to a significant degree. A computed tomography (CT) scan is the best method of evaluating the bony anatomy of the TMJ. The present report shows the surgical correction of the TMJ ankylosis. A 23-year-old female attended the hospital, showing severe mouth opening limitation (9 mm). On investigations, left TMJ ankylosis was diagnosed. The surgical approach consisted of distraction osteogenesis of the left side, followed by vigorous physiotherapy. In patients with TMJ ankylosis, restoration of normal function and jaw movement is difficult. This case report highlights the importance of physiotherapy as an emerging adjuvant therapy in the treatment of TMJ ankylosis. There have also been several treatment methods used to improve the patient\'s self-esteem and confidence, including speech therapy and psychological counseling.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    颞下颌关节(TMJ)强直导致错牙合,喂养不良,难以保持口腔卫生,和面部审美畸形。治疗颞下颌关节强直的基本手术目标是建立关节运动,防止复发,实现正常的生长发育。这里,我们提出了一个手术矫正下颌骨发育不全的手术病例;然而,患者在3年后因效果不理想而回来,并接受了双侧冠状动脉切除术和间隙关节成形术.在LeFortI水平对骨骼进行截骨切除,上颌段向下骨折并动员以与下颌骨咬合。在目前的情况下,下咽气道从治疗前的5毫米变为治疗后的10毫米,治疗后面部角度从73°变为84°。在高度怀疑阻塞性睡眠呼吸暂停的情况下进行咽气道评估,并且在TMJ强直的治疗中必须进行面部畸形。
    Temporomandibular joint (TMJ) ankylosis results in malocclusion, poor feeding, difficulty in maintaining oral hygiene, and facial esthetic deformity. The basic surgical objectives in the treatment of TMJ ankylosis are to establish joint movement, prevent relapse, and achieve normal growth and development. Here, we present an operated case ofsurgical correction of mandibular hypoplasia; however, the patient came back after three years due to unsatisfactory results and underwent bilateral coronoidectomy and gap arthroplasty. Bones were osteotomized at the LeFort I level and the maxillary segment was down-fractured and mobilized to bring into occlusion with the mandible. In the present case, the lower pharyngeal airway changed from 5 mm pre-treatment to 10 mm post-treatment, and the facial angle was changed from 73 to 84 post-treatment. Assessment of the pharyngeal airway is done with a high suspicion of obstructive sleep apnea and facial deformity is mandatory in the management of TMJ ankylosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    颞下颌关节(TMJ)强直的特征通常是复杂的病因,有几个原因,包括感染,自身免疫性疾病,创伤,和先天性异常。该病例报告描述了一名三岁的女性,患有创伤性颞下颌关节强直并伴有下颌后移,严重的张口限制,阻塞性睡眠呼吸暂停(OSA)。本案突出了TMJ强直的困难,尤其是当寻求医疗保健的时间较晚并且诊断延迟很普遍时。下颌骨牵张成骨和清醒的光纤插管用于这种情况的手术和麻醉管理,如果需要,耳鼻咽喉科团队待命进行气管切开术,强调在这种情况下采取多学科方法的必要性。TMJ强直患者有显著的改变生活的变化,包括心理压力,咀嚼困难,言语困难,面部变形,言语障碍。当OSA进展时,它也带来了更多的健康风险。为了治疗颞下颌关节强直,避免严重的问题,提高病人的幸福感,及时的诊断和治疗至关重要。为了优化患者结果,本案例研究强调了对TMJ强直治疗的知识和研究的需求,以及医疗专业人员以协同方式合作的需求。
    Temporomandibular joint (TMJ) ankylosis is generally characterised by a complex aetiology, with several contributing causes, including infections, autoimmune diseases, trauma, and congenital anomalies. This case report describes a three-year-old female suffering from traumatic temporomandibular ankylosis with retrognathia, severe mouth-opening restriction, and obstructive sleep apnea (OSA). The present case highlights the difficulties with TMJ ankylosis, especially when access to healthcare is sought out late and delayed diagnosis is prevalent. Mandibular distraction osteogenesis and awake fiberoptic intubation were used in the surgical and anaesthetic management of this case, with the otorhinolaryngology team on standby to perform a tracheostomy if required, highlighting the necessity of a multidisciplinary approach in such cases. Patients with TMJ ankylosis have significant life-altering changes, including psychological stress, chewing difficulty, speech difficulties, facial distortion, and speech impediment. When OSA progresses, it also presents more health risks. For the purpose of treating TMJ ankylosis, avoiding serious problems, and enhancing patient well-being, prompt diagnosis and therapy are crucial. In order to optimise patient results, this case study highlights the need for knowledge and research in the treatment of TMJ ankylosis as well as the requirement of medical professionals working together in a synergistic way.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    下颌骨髁状突发育不全和颞下颌关节(TMJ)强直是诊断和治疗的复杂挑战,影响下颌功能和面部美学。该病例报告介绍了一名5岁的女性儿童,由于左侧TMJ强直,右侧小颌和面部不对称。下颌髁突发育不全和TMJ强直的共存强调了对全面评估和量身定制治疗方法的需求。综合征协会,比如Goldenhar综合征和TreacherCollins综合征,进一步复杂的诊断和管理。在全身麻醉下,使用肋软骨移植物/颞肌筋膜进行涉及左侧间隙关节成形术和重建的手术干预。然而,术后并发症,包括张口减少和左侧下运动神经元面神经麻痹,需要进一步的手术清创和脓肿引流。该案例强调了多学科方法在解决复杂的颅面异常中的重要性,骨移植和量身定制的手术干预等治疗策略提供了有希望的结果。了解下颌髁突发育不全和TMJ强直的多方面病因对于优化治疗至关重要,强调实现良好的患者结果所需的协作努力。
    Mandibular condyle aplasia and temporomandibular joint (TMJ) ankylosis represent complex challenges in diagnosis and management, affecting jaw function and facial aesthetics. This case report presents a five-year-old female child with a right-sided small jaw and facial asymmetry due to left-sided TMJ ankylosis. The coexistence of mandibular condyle aplasia and TMJ ankylosis underscores the need for comprehensive evaluation and tailored treatment approaches. Syndromic associations, such as Goldenhar syndrome and Treacher Collins syndrome, further complicate diagnosis and management. Surgical intervention involving left-side gap arthroplasty and reconstruction using a costochondral graft/temporalis fascia was performed under general anesthesia. However, postoperative complications, including decreased mouth opening and left-sided lower motor neuron facial palsy, necessitated further surgical debridement and drainage of an abscess. The case emphasizes the importance of a multidisciplinary approach in addressing complex craniofacial anomalies, with treatment strategies such as bone grafting and tailored surgical interventions offering promising outcomes. Understanding the multifaceted etiology of mandibular condyle aplasia and TMJ ankylosis is crucial for optimal management, highlighting the collaborative efforts required for achieving favorable patient outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    为了探索YAP的作用,河马途径的一个关键效应,在颞下颌关节(TMJ)强直。在绵羊模型中,通过免疫组织化学和多重免疫组织化学在术后第1、4、7、9、11、14和28天检测YAP的时空表达。从第14天的样品分离的间充质干细胞(MSC)。在MSCs成骨诱导前后检测YAP的相对mRNA表达。构建了一个YAP沉默的MSC模型,并检查了YAP敲低对MSC功能的影响。YAP在决定强直形成的关键位点的细胞核中表达,表明YAP在生理状态下被激活。YAP的表达随时间逐渐增加。此外,与RUNX2标记的成骨活性区共表达RUNX2和YAP的细胞数量在第9天后趋于增加。MSCs成骨诱导后,YAP的表达增加。在沉默YAP之后,成骨,MSCs的增殖和迁移能力受到抑制。YAP参与TMJ骨性强直的早期发展。使用shRNA抑制YAP可能是预防或治疗TMJ强直的有希望的方法。
    To explore the role of YAP, a key effector of the Hippo pathway, in temporomandibular joint (TMJ) ankylosis. The temporal and spatial expression of YAP was detected via immunohistochemistry and multiplex immunohistochemistry on postoperative Days 1, 4, 7, 9, 11, 14 and 28 in a sheep model. Isolated mesenchymal stem cells (MSCs) from samples of the Day 14. The relative mRNA expression of YAP was examined before and after the osteogenic induction of MSCs. A YAP-silenced MSC model was constructed, and the effect of YAP knockdown on MSC function was examined. YAP is expressed in the nucleus of the key sites that determine the ankylosis formation, indicating that YAP is activated in a physiological state. The expression of YAP increased gradually over time. Moreover, the number of cells coexpressing of RUNX2 and YAP-with the osteogenic active zone labelled by RUNX2-tended to increase after Day 9. After the osteogenic induction of MSCs, the expression of YAP increased. After silencing YAP, the osteogenic, proliferative and migratory abilities of the MSCs were inhibited. YAP is involved in the early development of TMJ bony ankylosis. Inhibition of YAP using shRNA might be a promising way to prevent or treat TMJ ankylosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:评价肋软骨移植(CCG)治疗颞下颌关节强直(TMJA)的疗效。
    方法:将2010.5至2021.7接受CCG治疗的TMJA患儿纳入研究。手术前后进行CT扫描,随访至少1年。下颌支的高度,menton偏差或缩回,截骨间隙,等。采用ProPlanCMF1.4软件进行测量。CCG增长,再吸收,和复发的影响因素进行评估和分析,如年龄,手术间隙,等。通过广义估计方程。
    结果:研究中有24名患者(29个关节),平均年龄为6.30±3.13岁。手术后,下颌支延长5.97±3.53毫米。下颌偏斜或前缩分别校正4.82±2.84mm和3.76±2.97mm。平均随访38.91±29.20个月,CCG增长58.62%(4.18±7.70mm),吸收20.69%(2.23±1.16mm),和20.69%的人重新安稳。强直与截骨间隙呈负相关(OR:0.348,0.172-0.70295CI,临界值=6.10mm)。CCG吸收与CCG支伸长距离呈正相关(OR:3.353,1.173-9.58695CI,临界值=7.40mm)。
    结论:足够的截骨间隙和CCG支延伸距离是成功治疗TMJA伴颌骨畸形患者的关键因素。
    结论:TMJA影响小儿患者的张口和颌骨发育。儿童患者最常见的自体骨移植物是CCG,由于其生长潜力,方便的访问和容易的轮廓。此外,它可以通过延长下颌支同时重建TMJ并改善颌骨畸形。但是CCG的增长是不可预测的。在这项研究中,我们探讨了可能影响CCG吸收和再强直的几个因素,以期为今后CCG治疗提供几点改进建议。
    OBJECTIVE: To evaluate the effects of costochondral grafting (CCG) used for temporomandibular joint ankylosis (TMJA) in growing patients.
    METHODS: Pediatric patients with TMJA treated by CCG from 2010.5 to 2021.7 were included in the study. CT scans were performed before and after operations with at least 1 year follow-up. The height of the mandibular ramus, menton deviation or retraction, osteotomy gap, etc. were measured by ProPlan CMF1.4 software. CCG growth, resorption, and relapse were evaluated and analyzed with influencing factors such as age, ostectomy gap, etc. by generalized estimating equation.
    RESULTS: There were 24 patients (29 joints) with an average age of 6.30 ± 3.13 years in the study. After operation, the mandibular ramus was elongated by 5.97 ± 3.53 mm. Mandibular deviation or retrusion was corrected by 4.82 ± 2.84 mm and 3.76 ± 2.97 mm respectively. After a mean follow-up of 38.91 ± 29.20 months, 58.62% CCG grew (4.18 ± 7.70 mm), 20.69% absorbed (2.23 ± 1.16 mm), and 20.69% re-ankylosed. The re-ankylosis was negatively correlated with the osteotomy gap (OR:0.348,0.172-0.702 95%CI, critical value = 6.10 mm). CCG resorption was positively correlated with the distance of CCG ramus elongation (OR:3.353,1.173-9.586 95%CI, critical value = 7.40 mm).
    CONCLUSIONS: An adequate osteotomy gap and CCG ramus elongation distance are the key factors for successful treatment of TMJA with jaw deformities in growing patients.
    CONCLUSIONS: TMJA affects mouth opening and jaw development in pediatric patients. The most common autogenous bone graft for pediatric patients is CCG due to its growth potential, convenient access and easy contouring. Also, it can simultaneously reconstruct the TMJ and improve jaw deformity by lengthening the mandibular ramus. But the growth of CCG is unpredictable. In this study, we explored several factors that may affect the absorption and re-ankylosis of CCG, expecting to provide several suggestions to improve future CCG treatment.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    颞下颌关节(TMJ)强直是导致张口受限的TMJ疾病的一种形式,范围从部分复位到下颌的完全固定。骨性和纤维性强直最常见于外伤,虽然它也可能是手术的结果,局部或全身感染,或全身性疾病。儿童TMJ会产生面部畸形,随着增长而增加,并对患者的心理发展产生重大不利影响。每个患有颞下颌关节强直的患者都必须有病史,体检,和射线照相检查以确定明确的诊断,严重程度,周围组织受累,and,最终,治疗计划。技术挑战和高复发率使治疗TMJ强直具有挑战性。为患有TMJ强直的幼儿插管是一项艰巨的工作,有限的张嘴加剧了这种情况。这个病例报告描述了一个五岁的男孩,他报告说他无法张开嘴,诊断为TMJ强直,并在没有适当大小的气管造口管的情况下进行管理。
    Temporomandibular joint (TMJ) ankylosis is a form of TMJ condition that causes mouth opening limitation, ranging from partial reduction to total immobilization of the jaw. Bony and fibrous ankylosis is most commonly caused by trauma, although it can also happen as a result of surgery, local or systemic infections, or systemic diseases. Childhood TMJ produces facial deformities, which increase with growth and have a major detrimental impact on the patient\'s psychological development. Each patient with TMJ ankylosis must have a history, physical examination, and radiographic examination in order to determine a definitive diagnosis, severity, involvement of surrounding tissues, and, ultimately, treatment planning. Technical challenges and a high recurrence rate make treating TMJ ankylosis challenging. Intubating a young child with TMJ ankylosis is a difficult job, which is exacerbated by limited mouth opening. This case report describes a five-year-old boy who reported an inability to open his mouth, diagnosed as TMJ ankylosis, and managed in the absence of an appropriately sized tracheostomy tube.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    颞下颌关节强直(TMJ)与下颌运动受限有关,偏离受影响的一侧。TMJ强直的治疗包括手术以减轻强直的影响,和辅助矫治器疗法,以补充通过手术取得的成果。已经使用了几种器具来帮助维持手术后的下颌活动,但文献中很少记载。我们的系统评价旨在检查用于TMJ强直治疗的各种矫治器的临床结果。2022年7月对文献进行了全面的电子搜索,以确定合格的文章,这些文章测试了使用正畸或理疗器具来管理TMJ强直。总的来说,叙述综合中包括13种出版物。使用了通用和定制的电器,总体研究结果表明,使用这些矫治器改善了张口,减少了再次强直的机会。在这篇评论中,没有发现普遍接受的器具被使用,并且用于器械选择的标准不清楚.开发治疗TMJ强直的矫治器的研究领域是开放的,这篇综述将有助于指导该领域未来的研究。
    Ankylosis of the temporomandibular joint (TMJ) is associated with restricted mandibular movements, with deviation to the affected side. The management of TMJ ankylosis involves surgery to mitigate the effects of ankylosis, and adjunctive appliance therapy to supplement the results achieved through surgery. Several appliances have been used to help maintain jaw mobility postsurgery, but have been rarely documented in the literature. Our systematic review aimed to examine the clinical outcomes of various appliances for TMJ ankylosis management. A comprehensive electronic search of the literature was performed in July 2022 to identify eligible articles that had tested the use of orthodontic or physiotherapy appliances for the management of TMJ ankylosis. In total, 13 publications were included in the narrative synthesis. Both generic and custom-made appliances were used, with overall findings suggesting that using these appliances improved mouth opening and reduced chances of re-ankylosis. In this review no universally accepted appliance was found to be utilized, and the criteria used for appliance selection were unclear. The field of research in developing appliances for the treatment of TMJ ankylosis is open to advancement, and this review will help guide future research in this area.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    本报告描述了正在研究的颞下颌关节强直(TMJA)和肝外门静脉阻塞(EHPVO)的共同发生,探索涉及高凝的共享途径。TMJA是一种关节表面融合的获得性病理学,导致张口受限和面部不对称。全球范围内,TMJA在1.5至5名患者/百万中普遍存在,在发展中国家发病率较高。虽然创伤和感染经常引起TMJA,许多病例的发病机制尚不清楚.最近的文献指出TMJA和EHPVO之间存在联系,引起儿童门静脉高压和上消化道出血的非肝硬化血管疾病。血栓性疾病如蛋白C和S缺乏可能导致EHPVO,反映TMJA与高凝状态的关联。这份报告的重点是一名被诊断患有TMJA的11岁女性,伴有耳部感染史和并发EHPVO。我们进一步介绍了临床观察,手术干预,以及结果以及文献综述,以了解EHPVO和TMJA之间可能的联系。
    This report describes the understudied co-occurrence of temporomandibular joint ankylosis (TMJA) and extrahepatic portal vein obstruction (EHPVO), exploring a shared pathway involving hypercoagulability. TMJA is an acquired pathology where joint surfaces fuse, causing restricted mouth opening and facial asymmetry. Globally, TMJA is prevalent among 1.5 to 5 patients/million, with a higher incidence in developing countries. While trauma and infections often cause TMJA, the pathogenesis remains unclear in many cases. Recent literature notes a link between TMJA and EHPVO, a noncirrhotic vascular disorder causing portal hypertension and upper gastrointestinal bleeding in children. Prothrombotic disorders such as protein C and S deficiency may contribute to EHPVO, mirroring TMJA\'s association with hypercoagulability. This report focuses on an 11-year-old female diagnosed with TMJA, accompanied by a history of ear infection and concurrent EHPVO. We further presented clinical observations, surgical interventions, and outcomes alongside a literature review to understand the probable connection between EHPVO and TMJA.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:单侧颞下颌关节强直伴颌骨畸形(UTMJAJD)可能需要同时进行全关节假体(TJP)重建,矢状裂支(SSRO),还有LeFortI截骨术.这项研究的目的是评估接受这些手术治疗的患者的预后。
    方法:选择2016年至2018年诊断为UTMJAJD的患者进行研究。在强直释放后,在强直侧使用TJP,在对侧使用SSRO进行下颌骨先行手术。最后进行了LeFortI截骨术,有或没有进行生殖器成形术。最大门牙开口(MIO),面部对称,并比较了颌骨和髁的稳定性,手术后,在后续行动中。
    结果:7名患者被纳入研究。他们的平均下巴偏差为9.5±4.2mm,上颌斜度为5.1±3.0°。手术后,颌骨畸形明显改善,下巴偏差校正7.6±4.1mm(p=0.015),前进5.9±2.5mm(p=0.006)。平均随访26.6±17.1个月,MIO从11.4±9.3显著增加到35.7±2.6(p=0.000)。咬合稳定,下颌位置或旋转无明显变化(p>0.05)。随访期间未见明显髁突吸收。
    结论:同时TJP重建,SSRO,LeFortI型截骨术是治疗UTMJAJD的可靠有效方法。
    OBJECTIVE: Unilateral temporomandibular joint ankylosis with jaw deformity (UTMJAJD) may require simultaneous total joint prosthesis (TJP) reconstruction, sagittal split ramus (SSRO), and Le Fort I osteotomies. The purpose of this study was to evaluate outcomes in patients treated with these procedures.
    METHODS: Patients diagnosed UTMJAJD between 2016 and 2018 were selected for the study. Mandible-first procedure was performed after ankylosis release with TJP on the ankylosed side and SSRO on the contralateral side. Le Fort I osteotomy with and without genioplasty was lastly performed. Maximal incisor opening (MIO), facial symmetry, and jaw and condyle stability were compared before, after operation, and during follow-ups.
    RESULTS: Seven patients were included in the study. Their average chin deviation was 9.5 ± 4.2 mm, and maxillary cant was 5.1 ± 3.0°. After operation, jaw deformity significantly improved, with chin deviation corrected 7.6 ± 4.1 mm (p = 0.015) and advanced 5.9 ± 2.5 mm (p = 0.006). After an average follow-up of 26.6 ± 17.1 months, MIO significantly increased from 11.4 ± 9.3 to 35.7 ± 2.6 mm (p = 0.000). The occlusion was stable with no significant positional or rotational changes of the jaw (p > 0.05). There was no obvious condylar resorption during follow-ups.
    CONCLUSIONS: Simultaneous TJP reconstruction, SSRO, and Le Fort I osteotomy are reliable and effective methods for the treatment of UTMJAJD.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号