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Revista Española de Cirugía Oral y Maxilofacial
versão On-line ISSN 2173-9161versão impressa ISSN 1130-0558
Resumo
PINGARRON MARTIN, L. et al. Chronic recurring dislocation treatment: Norman glenotemporal osteotomy. Rev Esp Cirug Oral y Maxilofac [online]. 2009, vol.31, n.3, pp.160-166. ISSN 2173-9161.
Background. Various surgical procedures have been used to limit mandible opening in patients with recurrent dislocations of the temporo mandible joint (TMJ). These include intracapsular injection of sclerosing agents and tethering of the mandible. Other methods include obstruction of the condylar translation by downfracturing the zygomatic arch or by bone graft augmentation of the tuberculum and creating a mechanical impediment using Vitallium mesh or a stainless steel pin. Objective. To evaluate the author's experience in the treatment of recurrent dislocation of the mandible when both components, the osseous (eminence) and the muscular one (lateral pterigoideum), are treated. Material and methods. From January 1997 to August 2008, twenty-five patientes, 30 years old of averaged age, are affected by recurrent luxation (> 3 episodes/year). Twenty-one of them are treated primarily and four of them because of recurrences. The operative procedure is developed under general anesthesia, incising along the zygomatic arch using blunt dissection so that the front wall of the articular capsule can be exposed completely. An L-shaped plate is fixed bicortically with pins. Results. Radiological and clinical follow-up after the surgical treatment (6 to 36 months postoperatively) manifest the absence of lost graft, no recurrence, completed or partial pain remission, adequate mouth aperture and absence of important complications. Conclusion. The technique described for restricting TMJ movements in cases of chronic dislocation is relatively simple. The function of the TMJ was immediately normalized and no supplementary treatment was necessary.
Palavras-chave : Recurrent dislocation; Recurrent luxation; Glenotemporal osteotomy; Temporo mandible joint; Mini plate.