OBJECTIVES: The purpose of this study was to evaluate disk position and patient response 10 years after modified condylotomy for symptomatic reducing disk displacement. STUDY DESIGNS: Questionnaires and invitations to return for examination and temporomandibular joint magnetic resonance imaging were mailed to 39 consecutive patients 10 years after modified condylotomy. RESULTS: On a 10-point scale the mean pain experienced by the 17 respondents (27 joints) to the questionnaire was 2.0. Ninety percent of 20 joints (12 patients) examined were free of tenderness to palpation. Magnetic resonance imaging in 10 patients (17 joints) showed disk reduction in 59%, displacement with reduction in 29%, and displacement without reduction in 12%. Eighty-five percent of the joints met American Association of Oral and Maxillofacial surgeons criteria for a successful therapeutic outcome. CONCLUSIONS: The study suggests a role for modified condylotomy in the long-term management of symptoms associated with reducing disk displacement. Further, modified condylotomy can frequently reverse an internal derangement and seems to protect against the natural progression of osteoarthrosis.

Adult↗

PubMed1995

Soft tissue and bony enlargement of the mandible in an infant.

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Diagnosis, Differential↗

PubMed1993

Modified condylotomy for treatment of the painful temporomandibular joint with a reducing disc.

Data from a pool of approximately 400 patients operated on with modified condylotomy during a 9-year period are presented. The chief findings were good relief of pain and dysfunction, and reversal of the internal derangement in a high percentage of patients. There was low morbidity and remarkably few complications. Comparison of these findings with published results of alternative surgical and nonsurgical procedures seems to favor modified condylotomy.

Bone Remodeling↗

PubMed1993

Interpretation of disc-condyle relationships after modified condylotomy.

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Cartilage, Articular↗

PubMed1990

Audiometric assessment of patients with painful TMJ internal derangements: failure of audiometry to change following arthrotomy.

Thirteen patients with proven internal derangements of 16 temporomandibular joints were scheduled for arthrotomy. The patients' perception of otologic symptoms were recorded before surgery, and hearing was evaluated audiometrically both before and after surgery. There was no significant correlation between otologic symptoms and ipsilateral painful internal derangement of the temporomandibular joint. Perceived hearing loss was substantiated in only about half of the instances. Further, only about half of the ears with measured hearing loss (sensorineural) were associated with a painful internal derangement. Arthrotomy did not change any of the audiograms.

Adolescent↗

PubMed1989

Delayed management of a mandibular vascular malformation.

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Arteriovenous Malformations↗

PubMed1988

Use of porous hydroxylapatite blocks for augmentation of atrophic mandibles.

A clinical study of the use of porous blocks of hydroxylapatite (Interpore 200) for augmentation of atrophic residual mandibular ridges was performed. Fifteen patients each had three preoperatively customized blocks placed. They were then examined clinically and radiographically for at least 2 years. Six patients had skin-graft vestibuloplasties performed over the blocks 3 months after implantation; dentures were made for 11 of the patients. No clinical or radiographic evidence of migration or resorption of the blocks was found; however, all 15 patients suffered complications. Eleven developed ulcerations over the blocks with persistent exposure, six had suture line dehiscence leading to exposure, two infections occurred, and two patients developed chronic pain in the area of block insertion. The skin graft took only partially in all patients undergoing subsequent vestibuloplasties. To date, 37 of the original 45 blocks have required complete removal. Histologic examination of removed blocks has revealed partial filling of the pores with lamellar bone. The use of blocks of porous hydroxylapatite to reconstruct atrophic residual mandibular ridges was found to have an unacceptably high rate of failure and the ability to sustain an overlying split-thickness skin graft was unpredictable.

Aged↗

PubMed1987

Further refinement and evaluation of intraoral vertical ramus osteotomy.

Eighty-nine patients were treated with a modified procedure for intraoral vertical ramus osteotomy. Complications were virtually eliminated except for damage to the inferior alveolar nerve. Acute nerve damage occurred in about 36% of operated sides. Seventy-four percent of these damaged nerves recovered fully by one year. Only 8% of operated sides had persistent diminished sensation, usually mild, of the lower lip and chin. It is concluded that this technique should be seriously considered for mandibular ramus osteotomies when the mandible is going to be retruded or minimally moved in any other direction.

Cephalometry↗