自体冠突移植在颞下颌关节强直关节重建术中的应用

Application of joint reconstruction with autogenous coronoid process graft to treat temporomandibular joint ankylosis

目的:探讨自体冠突移植在颞下颌关节强直关节重建术中的应用及效果。方法:对2008年9月—2010年9月期间收治的9例颞下颌关节强直患者应用自体冠突移植关节重建术式治疗,间隙插补物采用自体关节盘或口腔生物膜,比较术前、术后开口度、咬合情况和锥形束CT检查结果。结果:术后随访12～24个月,术后最大开口度得到明显改善,咬合关系无改变,在随访期内,所有患者无复发。锥形束CT显示,移植冠突与下颌支骨性愈合,移植的冠突顶端变圆钝,向髁突形态转变。结论:自体冠突移植关节重建术是治疗颞下颌关节强直的有效术式。

PURPOSE： To evaluate the clinical effect of joint reconstruction by using autogenous coronoid process graft to treat temporomandibular joint（TMJ） ankylosis.METHODS： Nine cases of TMJ ankylosis from September 2008 to September 2010 were surgically treated by joint reconstruction with autogenous coronoid process graft,using autogenous articular disc or prosthodontic membrane as interpositional material.Mouth opening,occlusion and cone beam CT（CBCT） were used for evaluation before and after surgery.RESULTS： Satisfactory mouth opening was achieved in all patients and no one got occlusal changes or reankylosis during follow-up.CBCT showed that coronoid process graft reached bone union with the ramus and turned to be round.CONCLUSIONS： It is effective to cure TMJ ankylosis through joint reconstruction with autogenous coronoid process graft.