Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2015
Temporomandibular Joint Condylar Osteochondroma: Complete Condylectomy and Joint Replacement Versus Low Condylectomy and Joint Preservation.
Клиническое исследованиеСравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Mehra Pushkar, Arya Varun, Henry Charles
Аннотация
PURPOSE: Recommended treatment for patients with osteochondromas of the mandibular condyle is to perform complete condylectomy with joint replacement. Low condylectomy with joint preservation has recently been proposed as a treatment option. This study compared the outcomes of these treatment options in patients with condylar osteochondromas.
PATIENTS AND METHODS: Patients were divided into 2 groups: patients who underwent complete condylectomy and joint replacement (group A, n = 13) and patients who underwent low condylectomy and joint preservation (group B, n = 8). To optimize occlusion, function, and esthetics, maxillary and mandibular orthognathic procedures were performed as necessary to re-establish vertical ramus height. Outcomes were measured clinically and radiographically.
RESULTS: The 2 groups showed significant clinical improvement (P < .05), with no tumor recurrence. Group A had increased operating room (OR) time and donor-site complications in those who received autogenous joint reconstruction compared with alloplastic joint replacement. Group B had a shorter OR duration with quicker postoperative recovery. Orthognathic procedures were stable in all cases.
CONCLUSIONS: Complete and low condylectomies are viable options for the surgical management of osteochondromas of the mandibular condyle. If temporomandibular joint (TMJ) reconstruction is required, patient-fitted TMJ replacements provide similar clinical outcomes as autogenous reconstruction, but have the advantages of eliminating donor-site morbidity and decreasing operating time.
PATIENTS AND METHODS: Patients were divided into 2 groups: patients who underwent complete condylectomy and joint replacement (group A, n = 13) and patients who underwent low condylectomy and joint preservation (group B, n = 8). To optimize occlusion, function, and esthetics, maxillary and mandibular orthognathic procedures were performed as necessary to re-establish vertical ramus height. Outcomes were measured clinically and radiographically.
RESULTS: The 2 groups showed significant clinical improvement (P < .05), with no tumor recurrence. Group A had increased operating room (OR) time and donor-site complications in those who received autogenous joint reconstruction compared with alloplastic joint replacement. Group B had a shorter OR duration with quicker postoperative recovery. Orthognathic procedures were stable in all cases.
CONCLUSIONS: Complete and low condylectomies are viable options for the surgical management of osteochondromas of the mandibular condyle. If temporomandibular joint (TMJ) reconstruction is required, patient-fitted TMJ replacements provide similar clinical outcomes as autogenous reconstruction, but have the advantages of eliminating donor-site morbidity and decreasing operating time.