a b s t r a c tIntroduction: In cases of temporomandibular joint (TMJ) ankylosis, interposition arthroplasty allows return of functional jaw movements. In order to improve the facial appearance, distraction osteogenesis is the treatment of choice, and may be timed either as a prearthroplastic, simultaneous or post-arthroplastic procedure. This study was planned to compare the treatment outcomes of pre-arthroplastic distraction (PAD) and simultaneous arthroplastic distraction (SAD) to establish the better treatment modality in terms of improvement in function and aesthetics. Materials and methods: This prospective randomized experimental study included 20 children and adolescents suffering from facial deformity due to long standing unilateral TMJ ankylosis. They were randomly allocated to the two surgical groups with ten in each group. Result: Both groups resulted in good facial symmetry and aesthetics. Initially, during the distraction period, mouth opening of SAD group scored less than that of PAD group but became comparable in 30 days. More pain at the distraction site and over the normal TMJ was observed in PAD group. The excursive movements were almost comparable in both the groups. Conclusion: We conclude that both procedures are effective in correcting the postankylotic deformity and improving function. Although PAD has better control over movement of the distracting segment, the contralateral TMJ may experience pain.SAD requires a shorter management period but is associated with a temporary decrease in function. Also, control of distraction may be difficult and chances of reankylosis are always there.
Introduction: The goal in treating Hemifacial microsomia (HFM) is to improve facial symmetry, allow functional jaw movement, obtain stable occlusion, and achieve patient satisfaction. This study was planned with an aim to assess the outcome of simultaneous maxillomandibular distraction osteogenesis in hemifacial microsomia. Material & methods: Seven patients with hemifacial microsomia were included in this study and demographic data was obtained. Simultaneous maxillo-mandibular distraction was planned for correction of maxillary cant, vertical ramal lengthening and midline, by performing unilateral mandibular osteotomy in ramus and distractor fixation, a Le Fort I osteotomy, with fixation at contralateral zygomatic buttress and intermaxillary elastics. Derriford Appearance Scale was used to measure individual responses to address problems of appearance. Results: 6 males and 1 female, with age range 18-26 years, mean 22.14 were included in the study. Maxillary occlusal cant varied from 4-16 , mean 9.85 and distraction achieved ranged from 12-19 mm, mean 15.57. Preoperatively DAS score ranged from 42-61, mean 51.7 and improved to 10-27, mean 18.4. 100% success was achieved in 5 cases, while other two showed 96% and 99% success. Conclusion: Simultaneous maxillomandibular distraction osteogenesis improves facial esthetics and obviates the need for postoperative orthodontics, minimizing the treatment period.
Background: Dentigerous cyst (DC) is the second most common cyst of the jaw after radicular, affecting mostly the permanent dentition in the mandible (70%). DC Of maxillary sinus involving ectopic teeth is rare. Case details: We report a case of DC of maxillary sinus as well as anterior mandible associated with ectopic teeth, in a non-syndromic 8 years old boy who underwent cyst enucleation along with extraction of the involved teeth. Conclusion: DC affecting both maxilla and mandible is a less common entity. Treatment modality can range from enucleation to simple marsupilisation depending upon the extent of the lesion.
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