Treatment of Ankylosis.ppt

Treatment of Ankylosis
of Temporomandibular Joint
Definition: intra-articular and extra-articular processes may restrict jaw motion severely. Ankylosis of the TMJ is an intra-articular process characterized by fibrous, fibro-osseous, or osseous obliteration(消失) of the joint space. Extracapsular causes of restricted jaw motion (pseudoankylosis) include but are not limited to coronoid-zygomatic fusion(融合), coronoid hypertropy, and muscular fibrosis.
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Indications for therapy for ankylosis
(may include one or more of the following)
Severely restricted jaw motion panied by one or more of the following:
Inadequate masticatory function
Abnormal speech
Inability to undergo dental and /or medical promised anesthetic management
Inhibited facial growth
Imaging evidence of osseous or soft tissue abnormality
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Presence of a general therapeutic goal
B. Release of ankylosis
C. Access for dental and/or medical care
D. Improved speech
E. Improved masticatory function
F. Relief or reduction of pain
Specific Therapeutic Goals for Ankylosis
(The goal of therapy is to restore form and/or function. However, risk factors and plications may preclude(妨碍) complete restoration of form and/or function)
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Specific Factor Affecting Risk for Ankylosis
(Severity factors that increase risk and the potential for plications)
Presence of a general factor effecting risk
Type of ankylosis (ie, fibrous or bony)
C. Etiology of the ankylosis (eg, traumatic or inflammatory)
D. Extent and duration of ankylosis
E. Degree of pre-existing muscular atrophy
F. Ankylosis in a growing child
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Indicated therapeutic standards for ankylosis
General history and physical examination
Focused history and physical examination of the TMJ regionto region to determine the presence of indications for care of ankylosis and to identify factors affecting risks
An imaging examination, if indicated, based on the history andphysical findings. The examination may include but is not limited to: panoramic radiograp