1/62. Assessment, documentation, and treatment of a developing facial asymmetry following early childhood injury.Prepubertal trauma is often implicated as the cause of asymmetric growth of the mandible. A series of photographs taken before and after early childhood injury to the orofacial complex illustrates the development of a three-dimensional dentofacial deformity in a patient. The diagnosis and combined surgical orthodontic treatment plan to correct the facial asymmetry and malocclusion are discussed.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/62. Eminectomy for the treatment of recurrent temporomandibular joint dislocation.Several techniques have been used to treat chronic dislocation of the mandible. Most of these techniques represent attempts at reducing the mobility of the TMJ. The eminectomy procedure is an attempt at restoring normal joint function without reducing mobility of the joint. We have presented two cases of chronic dislocation of the mandible that were treated successfully by removal of the articular tubercle and the lateral portion of the temporal bone. Although surgery of the TMJ area may be hazardous if approached without caution, we feel that the complications associated with this procedure are minimized if adequate care is taken in flap design and tissue dissection. On the basis of the excellent results of the eminectomy procedures reported in the literature and of our own experience with this procedure, we feel that this is the preferred treatment for chronic dislocation of the mandible.- - - - - - - - - - ranking = 3keywords = mandible (Clic here for more details about this article) |
3/62. Dislocation of the condyle into the middle cranial fossa.Surgical intervention by a preauricular approach appears to be the preferred treatment in this rare injury. It does not appear necessary or wise to disimpact the condyle as it presents more of a surgical risk and its presence in the cranial fossa seems to pose no neurological problems. The use of an interposing medium, placed after the teeth are secured in occlusion, appears to be definitely indicated to prevent ankylosis and, hopefully, to eliminate deviation of the mandible. A carved piece of Silastic, designed to conform to the recontoured roof of the glenoid fossa, has produced excellent results in cases of ankylosis; it served well in this case. Silastic has the advantages of being easy to carve, it may be attached to the rim of the fossa, and it is extremely nonirritating; it eventually becomes encased in a fibrous capsule.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
4/62. Unilateral mandible fracture with bilateral TMJ dislocation.temporomandibular joint (TMJ) dislocation occurs when the condylar head slips forward causing the posterior articulating surface of the condyle to advance ahead of the articular eminence, possibly becoming entrapped. Following dislocation, the ligaments around the joint often stretch, causing severe muscle spasms and joint pain. There is no standard evaluation and treatment method for acute TMJ dislocation, but the most effective course is immediate reduction. This paper presents a 42-year-old woman who sustained a unilateral mandible fracture with bilateral TMJ dislocation in an automobile crash. Although the fracture was apparent on plane film and panorex, the dislocation was not found until six weeks later, when the jaw was unwired. At that time, the dislocation was suspected because of decreased range of motion, but was not verified until an MRI was performed. The result was long-term therapy, eventual bilateral TMJ surgery, and chronic TMJ pain for the patient.- - - - - - - - - - ranking = 5.0889404276567keywords = mandible, jaw (Clic here for more details about this article) |
5/62. Inverted L-shaped ramus osteotomy for prolonged bilateral dislocation of the temporomandibular joint.The various methods of management of prolonged bilateral anterior dislocation of the temporomandibular joints are discussed and the literature is reviewed. Reported is a case in which a bilateral inverted L-shaped ramus osteotomy was performed in order to reposition the mandible and establish normal occlusion; the results were satisfactorily maintained one year postoperatively.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
6/62. External pterygoid myotomy for recurrent mandibular dislocation. review of the literature and report of a case.Dislocation of the temporomandibular joint is a condition that requires immediate attention. Several conservative methods are effective in the treatment of the acute episode, but surgical treatment is indicated for chronic dislocation. Many, sometimes conflicting, procedures have been proposed for the surgical treatment of chronic dislocation. Comprehensive review and analysis of the literature reveals that this confusion is generated by a poor understanding of the etiology of chronic dislocation. External pterygoid myotomy is recommended as the surgical treatment of choice since it eliminates the forces responsible for pulling the mandible into the dislocated position. A case is presented to demonstrate the effectiveness of this procedure.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
7/62. Sevoflurane mask anesthesia for urgent tracheostomy in an uncooperative trauma patient with a difficult airway.PURPOSE: Proper care of the trauma patient often includes tracheal intubation to insure adequate ventilation and oxygenation, protect the airway from aspiration, and facilitate surgery. airway management can be particularly complex when there are facial bone fractures, head injury and cervical spine instability. CLINICAL FEATURES: A 29-yr-old intoxicated woman suffered a motor vehicle accident. Injuries consisted of multiple abrasions to her head, forehead, and face, right temporal lobe hemorrhage, and complex mandibular fractures with displacement. mouth opening was <10 mm. blood pressure was 106/71 mm Hg, pulse 109, respirations 18, temperature 37.3 degrees C, SpO2 100%. Chest and pelvic radiographs were normal and the there was increased anterior angulation of C4-C5 on the cervical spine film. Drug screen was positive for cocaine and alcohol. The initial plan was to perform awake tracheostomy with local anesthesia. However, the patient was uncooperative despite sedation and infiltration of local anesthesia. Sevoflurane, 1%, inspired in oxygen 100%, was administered via face mask. The concentration of sevoflurane was gradually increased to 4%, and loss of consciousness occurred within one minute. The patient breathed spontaneously and required gentle chin lift and jaw thrust. A cuffed tracheostomy tube was surgically inserted without complication. Blood gas showed pH 7.40, PCO2 35 mm Hg, PO2 396 mm Hg, hematocrit 33.6%. Diagnostic peritoneal lavage was negative. Pulmonary aspiration did not occur. Oxygenation and ventilation were maintained throughout the procedure. CONCLUSION: Continuous mask ventilation with sevoflurane is an appropriate technique when confronted with an uncooperative trauma patient with a difficult airway.- - - - - - - - - - ranking = 0.088940427656688keywords = jaw (Clic here for more details about this article) |
8/62. Surgical orthodontic treatment of skeletal Class III malocclusion with anterior disc displacement without reduction (ADNR): a case report.A female patient with skeletal problems and left temporomandibular joint (TMJ) derangement was treated with an occlusal splint, arthroscopic irrigation, and orthodontic surgery. The left side disc was displaced anteriorly without reduction; and mobility of the left condylar head was restricted. With arthroscopic irrigation, the jaw functions were recovered, but the disc position remained the same. After TMJ therapy, orthodontic and orthognatic surgery treatments were performed to correct the dentofacial deformity. Stable facial esthetics and occlusion devoid of temporomandibular joint disorder (TMD) symptoms were obtained and the patient's progress was monitored over a 5-year period.- - - - - - - - - - ranking = 0.088940427656688keywords = jaw (Clic here for more details about this article) |
9/62. Failed closed reduction of a bifocal mandibular fracture because of dislocation of the mandibular ramus behind the styloid: case report.We present an unusual dislocation of the mandibular ramus after a low condylar fracture associated with a fracture of the opposite body of mandible. As closed reduction failed, both fracture sites were exposed. The mandibular ramus was dislocated behind the styloid process, which was not shown on the preoperative radiographs. The intermediate fragment was freed and the fractures treated by miniplate osteosynthesis. The patient made an uneventful recovery with no residual deformity.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
10/62. Dynamic magnetic resonance imaging technique for the study of the temporomandibular joint.AIMS: Echo planar imaging (EPI) is an ultrafast magnetic resonance imaging (MRI) technique that can scan a single frame in less than a second. The aim of this study was to use the EPI technique to develop a new dynamic MRI protocol for the temporomandibular joint (TMJ). methods: Basic fast-field echo and EPI pulse sequences were used for dynamic studies of the TMJ. The subjects were instructed to perform spontaneous, continuous, slow opening/closing movements without visual or audio feedback. Different scanning parameter settings were explored to optimize the results. RESULTS: With an opening/closing movement of approximately 6 to 7 seconds per cycle, the proposed protocol yielded a good insight into the relative motion between condyle and disc. It was also possible to see the deformation of the disc during movement. CONCLUSION: The EPI technique is a non-invasive technique that can be used for dynamic imaging study of a slow but continuous, uninterrupted jaw movement.- - - - - - - - - - ranking = 0.088940427656688keywords = jaw (Clic here for more details about this article) |
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