Minoo Mahshid; Mohammad Mehdi Zamiri; Masoud Ejlali; Masoud Varshosaz; Ghassem Ansari
Abstract
Aim: Improvement of clinical signs like pain and mandibular movements' restriction with capturing the natural disc location are among the main purpose of occlusal appliance therapy for the patients affected by internal derangement. The aim of this investigation was to determine the disc location and ...
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Aim: Improvement of clinical signs like pain and mandibular movements' restriction with capturing the natural disc location are among the main purpose of occlusal appliance therapy for the patients affected by internal derangement. The aim of this investigation was to determine the disc location and clinical findings in internal derangement patients, treated by an interocclusal appliance.
Materials and Methods: A total of 15 patients affected by internal derangement were selected on the basis of defined including and excluding criteria for treatment using a maxillary stabilization appliance. Patients were under detailed assessment in three occasions of before treatment, two and six months after the treatment. This was to determine the disc location in magnetic resonance imaging view and the effect of appliance on clinical findings like joint pain and mandibular movements restrictions. Descriptive statistical analysis and Friedman nonparametric test were used to analyse the data (SPSS Ver. 12.0)
Results: Improvements in clinical findings were observed in all (100%) patients after 2 months from the beginning of treatment and continued to be at 60% rate at the end of treatment. This improvement was found to be statistically significant when compared to other treatment sequences (P<0.001). Disc shape remained unchanged after treatment (23 in normal condition and 7 deformed). In open position, 11 joints were diagnosed as normal, 7 joints with disc dislocation and reduction, 12 joints without reduction before and after treatment while only one joint was added to normal group from the dislocated discs groups with reduction. Statistical analysis did not show any significant difference between disc location before and after treatment.
Conclusion: Stabilization appliance improves clinical findings without disc recapturing. Continuous use of the appliance until six months increase, the treatment success rate in comparison to 2 months use (IJO 2006;1:145-53).
Gholamreza Shirani; Farnoosh Mohammadi; Mohsen Shirazi
Abstract
Purpose: The long-term outcome and clinical results of gaparthro plasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared.
Materials and Methods: A nonrandomized, retrospective ...
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Purpose: The long-term outcome and clinical results of gaparthro plasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared.
Materials and Methods: A nonrandomized, retrospective clinical study of 10 cases of condylar ankylosis (18 Joints) of the mandible surgically treated during a 12 year period from 1990 to 2002 was performed. Four patients were treated by condylectomy and interpositional Flap and Six patients were treated by condylectomy and Immediate costachondral rib grafts.
The First group underwent long-term postoperative therapy using removable activator appliances. Casts, radiographs, photographs, computed tomography (CT) Scans, were Used post surgically to evaluate rib graft, condylar growth and function, occlusion, and Facial and condylar symmetry.
Results: Symmetry, arch coordination, correction of occlusal canting, mandibular deviation, facial growth , and prevention of reandkylosis were obtained and better controlled in those cases that cnderwent long-tern orthodontic activator therapy post operatively and were followed closely.
Conclusions: Children with long-standing condylar ankylosis of the mandible and its resultant facial asymmetry and occlusal canting (Secondry to a non functional joint and Maxillary compensation) treated with condylectomy and interpositional flap treated more favorably when activators were used postsurgically. The patients that failed to comply with or continue activator therapy postsurgically developed complications relating to mandibular deviation , occlusal dysharmony, asymmetry and rankylosis of the temporo mandibular joint (TMJ).
