Luxación crónica recidivantetratamiento, osteotomía glenotemporal de Norman
- Lorena Pingarrón Martín
- José Luis Cebrián Carretero
- Javier González Martín-Moro
- José M.ª López-Arcas Calleja
- Manuel Chamorro Pons
- C. Navarro Cuéllar
- Miguel Burgueño García
ISSN: 1130-0558
Year of publication: 2009
Volume: 31
Issue: 3
Pages: 160-169
Type: Article
More publications in: Revista española de cirugía oral y maxilofacial: Publicación Oficial de la Sociedad Española de Cirugía Oral y Maxilofacial
Abstract
Background. Various surgical procedures have been used to limit mandible opening in patients with recurrent dislocations of the tempora mandible joint (TM¡). These include intracapsular injection sclerosing agents and tethering of the mandible. Other methods include obstruction of the condylar translation by downfracturing the zygomatic arch or by bone graft augmentation of the tuberculum and creating a mechanical impediment using Vitallium mesh or a stainless steel pin. Objective. To evaluate the author's experience in the treatment of recurrent dislocation of the mandible when both components, the osseous (eminence) and the muscular one (lateral pterigoideum), are treated. Material and methods. From January 1997 to August 2008, twenty-five patients, 30 years old of averaged age, are affected by recurrent luxation (>3 episodes/year). Twenty-one of them are treated primarily and four of them because of recurrences. The operative procedure is developed under general anesthesia, incising along the zygomatic arch using blunt dissection so that the front wall of the articular capsule can be exposed completely. An L-shaped plate is fixed bicortically with pins. Results. Radiological and clinical follow-up after the surgical treatment (6 to 36 months postoperatively) manifest the absence of lost graft, no recurrence, completed or partial pain remission, adequate mouth aperture and absence of important complications. Conclusion. The technique described for restricting TM] movements in cases of chronic dislocation is relatively simple. The function of the TMJ was immediately normalized and no supplementary treatment was necessary.