Open AccessAn alternative approach for treating severe injured temporomandibular joints by gunshot wounds
Author(s) -
Tâmara Melo Nunes Ota,
Ana Paula Guerreiro Rodrigues Couto,
Sílvio Augusto Fernandes de Menezes,
João de Jesus Viana Pinheiro,
Ana Elisa Ribeiro
Publication year - 2019
Publication title -
annals of maxillofacial surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.365
H-Index - 6
ISSN - 2231-0746
DOI - 10.4103/ams.ams_35_19
Subject(s) - medicine , temporomandibular joint , condyle , fixation (population genetics) , occlusion , surgery , dentistry , orthodontics , population , environmental health
Temporomandibular joint (TMJ) reconstruction is a challenging clinical problem that has been revolutionized due to the development of total alloplastic TMJ replacement (TMJ-TJR); however, the costs are still very high. We used an alternative approach to treat comminuted mandibular condyle fracture with an unviable condyle head caused by gunshot wounds. Our surgical technique consisted of an extended preauricular incision; removal of the fractured condyle, bone fragments, and foreign bodies; reshape/flattening of the fracture edge; fixation of the articular disc (if viable); lining of the TMJ with temporalis muscle/fascia; application of Erich arch bars; and early elastic therapy. We successfully used this approach in five sequential cases that resulted in a good mouth opening (>35 mm) and satisfactory occlusion with teeth in maximum intercuspation. We believe that this technique is an excellent option for treating severe injured TMJs in places where TMJ-TJR is not available.