Anquilose da articulação têmporo-mandibular

Abstract

A anquilose pode ser definida como sendo a fusão das superfícies articulares e seu tratamento é um verdadeiro desafio devido à alta taxa de recorrência. OBJETIVO: Descrever seis casos clínicos tratados pela técnica da reconstrução articular, avaliar os resultados dessas cirurgias e fazer uma revisão da literatura. METODOLOGIA: A população estudada neste estudo retrospectivo foi obtida dos prontuários do hospital universitário e tinha que ter sido submetida a cirurgia para tratamento de anquilose por reconstrução aloplástica ou autógena entre os períodos de março de 2001 e outubro de 2005. Dados como a máxima abertura de boca (MAB), etiologia, tipo de anquilose e tratamento, e ocorrência de recidiva e lesão do nervo facial foram coletados no pré-operatório, através dos prontuários, e no pós-operatório, através de entrevista. RESULTADOS: A média da MAB no pré-operatório foi de 9,6mm (0 a 17mm) e no pós-operatório foi de 31,33mm (14mm a 41mm), não houve lesão do nervo facial e apenas em um caso houve recidiva da anquilose. CONCLUSÃO: A reconstrução da articulação com material autógeno ou alógeno, para o tratamento da anquilose da ATM se mostrou eficaz em relação à MAB pós-operatória, recidiva e função da articulação.

Utilização da tomografia computadorizada para o diagnóstico da articulação temporomandibular

“…Thus, it will be exposed and described in this paper the tomographic characteristics of normality, morphological changes and pathological conditions most commonly found in the temporomandibular joint region, besides some relevant information. of fibrocartilage integrity, allows the entry of fibrous connective tissue in the joint which, subsequently, results in ossification, leading to fusion of the mandibular condyle to the articular surface of the bone temporal 7 . As for the tomographic image can be observed that the condyle is filled by temporal bone, and a hipodense area within the lesion, which represents a remaining interarticular disk 7 ( Figure 2).…”

“…As for the tomographic image can be observed that the condyle is filled by temporal bone, and a hipodense area within the lesion, which represents a remaining interarticular disk 7 ( Figure 2). The TMJ ankylosis can be classified according to the type of tissue involved, bone, fibrous or fibro -osseous, or according to the location, intra-or extra -capsular 7 .…”

“…When it occurs in children can be a deterrent to normal mandibular growth, resulting in a mandibular hypoplasia, especially if there is a bilateral problem 7 .…”

“…The TMJ ankylosis is a rare condition and constitutes, still, a difficult disease to treat, which can cause problems in chewing, digestion, speech, appearance and hygiene, which can also lead to psychological problems 7 . It is characterized by changes in grip of fibrous tissue with bone setting condyle, glenoid fossa, zygomatic arch, and in some cases, the coronoid process of the mandible, promoting calcification of these structures with limited mouth opening and mandibular mobility, usually without painful symptoms.…”

“…It is characterized by changes in grip of fibrous tissue with bone setting condyle, glenoid fossa, zygomatic arch, and in some cases, the coronoid process of the mandible, promoting calcification of these structures with limited mouth opening and mandibular mobility, usually without painful symptoms. Its etiopathogenesis is associated with condylar fractures, advanced arthritis, infections and traumas 2,7 , this last one being the main cause of TMJ ankylosis, where there is the hypothesis that the extravasation of blood into the connective along with the disruption Planning is the loss of convexity of the condylar processes or articular eminence, as a local defect of the thinning of the compact bone layer 7 . This is an adaptive change to the first change of a disease or a degenerative secondary change to internal derangement or resulting from an overload on ATM.…”