Pathological changes after the surgical creation of a vertical intracapsular condylar fracture

Long, Xing; Goss, Alastair N.

doi:10.1016/j.ijom.2007.06.002

Cited by 16 publications

(7 citation statements)

References 29 publications

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“…In the present study, we observed typical Y-shaped bifid condyles in the area of the TMJ complexes, which are associated with traumatic TMJ ankylosis [ 5 , 28 , 29 ]. Clinical observations and other animal experiments have also reported similar results in the past [ 5 , 29 ]. We also attributed this Y-shaped bifid condyle formation to the distraction osteogenesis effect of the lateral pterygoid muscle during the SFMC healing process.…”

Section: Discussionmentioning

confidence: 85%

“…Temporomandibular joint (TMJ) ankylosis is characterized by stiffening of the joint due to abnormal adhesion and rigidity of the relevant bones after injury or disease. This condition has significant effects on physical and mental health and results in a poor quality of life, with symptoms including trismus, masticatory difficulty, speech impairment, and pain [ 1 – 5 ]. In clinical practice, the most common cause of TMJ ankylosis is trauma, with sagittal fracture of the mandibular condyle (SFMC) being the primary etiology [ 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…This condition has significant effects on physical and mental health and results in a poor quality of life, with symptoms including trismus, masticatory difficulty, speech impairment, and pain [ 1 – 5 ]. In clinical practice, the most common cause of TMJ ankylosis is trauma, with sagittal fracture of the mandibular condyle (SFMC) being the primary etiology [ 2 , 4 , 5 ]. The treatment of TMJ ankylosis is difficult, although various treatment techniques have been reported [ 1 , 2 , 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The treatment of TMJ ankylosis is difficult, although various treatment techniques have been reported [ 1 , 2 , 4 – 7 ]. It has been hypothesized that traumatic TMJ ankylosis occurs after condylar fracture [ 4 , 5 , 7 ], although the organization and ossification of an intracapsular hematoma secondary to TMJ injury has also been thought to cause this condition [ 8 , 9 ]. Thus, the pathogenesis of traumatic TMJ ankylosis remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Influence of the lateral pterygoid muscle on traumatic temporomandibular joint bony ankylosis

Deng

Liu

et al. 2016

BMC Oral Health

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BackgroundThe pathogenesis of traumatic TMJ ankylosis remains unclear. This study aimed to verify the role of the lateral pterygoid muscle in the pathogenesis of traumatic temporomandibular joint (TMJ) bony ankylosis.MethodsEight 6-month-old male sheep were used in this study. Bilateral TMJ osteotomies were performed to induce sagittal fractures of the mandibular condyle. The lateral one-fourth segment of the disc was removed to establish a model of TMJ bony ankylosis. Subsequently, the function of the left and right lateral pterygoid muscles was blocked (experimental group) or maintained (control group), respectively. At 12 weeks postoperatively, animals were sacrificed and TMJ complex samples were evaluated by gross observation, spiral computed tomography (CT), micro-CT, and histological examinations.ResultsGross observation revealed bony ankylosis in the control TMJs and fibrous adhesions in the experimental TMJs. Spiral CT and micro-CT demonstrated that, compared to the experimental group, the control group showed calcified callus formation in the joint space and roughened articular surfaces after new bone formation, which protruded into the joint space. Maximum mediolateral and anteroposterior condylar diameters were significantly larger in the control group than in the experimental group. Micro-CT also showed that the primary growth orientation of new trabeculae was consistent with the direction of lateral pterygoid traction in the control group, but not in the experimental group. Histological examination showed fibro-osseous ankylosis in the control group, but not in the experimental group.ConclusionsThe lateral pterygoid simulates the effects of distraction osteogenesis, which is an important factor in the pathogenesis of TMJ bony ankylosis during the healing of sagittal condylar fractures.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Influence of the lateral pterygoid muscle on traumatic temporomandibular joint bony ankylosis

Deng

Liu

et al. 2016

BMC Oral Health

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“…In addition, because the temporomandibular joint (TMJ) is involved in pronunciation, mastication, and swallowing, inappropriate treatment may cause complications, such as pain, limitation of mouth opening, myospasm, mandibular displacement, malocclusion, pathologic change, osteonecrosis, facial asymmetry, and ankylosis, which may have a direct impact on the patient's life [1][2][3][4][5][6][7]. Especially in post-traumatic TMD, Long and Goss [4] reported that vertical condylar fractures in the joint space may induce pathological changes, such as osteoarthritis, and resultant ankylosis can cause complications such as limited mouth opening. Sanders et al [5], and Bear and Tankersley [6] also reported that development of TMJ osteoarthritis or ankylosis occurs in most patients with condylar fractures.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Temporomandibular Joint Disorder by Alloplastic Total Temporomandibular Joint Replacement

Roh¹,

Lee²,

Geum³

et al. 2013

The Journal Of Korean Association of Maxillofacial Plastic and

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The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.

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Open versus closed reduction: diacapitular fractures of the mandibular condyle

Chrcanovic

2012

Oral Maxillofac Surg

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The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical therapy. If conducted properly, surgical treatment of DFs is a safe and predictable procedure and yields good results.

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Pathological changes after the surgical creation of a vertical intracapsular condylar fracture

Cited by 16 publications

References 29 publications

Influence of the lateral pterygoid muscle on traumatic temporomandibular joint bony ankylosis

Influence of the lateral pterygoid muscle on traumatic temporomandibular joint bony ankylosis

Treatment of Temporomandibular Joint Disorder by Alloplastic Total Temporomandibular Joint Replacement

Open versus closed reduction: diacapitular fractures of the mandibular condyle

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