Journal of Temporomandibular Joint
Online ISSN : 1884-4308
Print ISSN : 0915-3004
ISSN-L : 0915-3004
Volume 28, Issue 1
Displaying 1-5 of 5 articles from this issue
proceedings
  • Takanori SHIBATA, Kenichi KURITA, Kaoru KOBAYASHI, Masashi SUGISAKI, T ...
    2016 Volume 28 Issue 1 Pages 3-13
    Published: April 20, 2016
    Released on J-STAGE: May 23, 2016
    JOURNAL FREE ACCESS
    Although the incidence of temporomandibular joint dislocation is expected to increase with population aging, there is no data to support it. Furthermore, much remains unknown about the pathophysiology of temporomandibular joint dislocation, especially unreduced dislocation or habitual dislocation, as well as effective treatment modalities and outcomes of various methods for preventing recurrence. We conducted a retrospective questionnaire of patients with temporomandibular joint dislocation in 2012 in order to predict the dynamics incidence of those patients, especially with unreduced dislocation or habitual dislocation, with the increase of population aging. The results suggest that many patients with temporomandibular joint dislocation have not been treated. We consider it is necessary to study the incidence of patients with unreduced dislocation or habitual dislocation of the temporomandibular joint. We describe an outline of the latter after dividing the treatment modalities of temporomandibular joint dislocation into various methods of reducing joint dislocation and various methods for preventing recurrence. Further studies are needed to determine the long-term treatment outcome of such prevention methods.
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  • Natsuki SEGAMI
    2016 Volume 28 Issue 1 Pages 14-21
    Published: April 20, 2016
    Released on J-STAGE: May 23, 2016
    JOURNAL FREE ACCESS
    Temporomandibular joint (TMJ) dislocation has increased in elderly patients with dementia. The treatment strategy is complicated which leads to social issues in today's aging society. This paper proposes a reasonable flow-chart for surgical treatment based on experience and bibliographic considerations. Surgical procedures were performed in 61 of 77 patients excluding arthroscopic eminoplasty and the procedure in 8 recurrent cases was eminectomy alone. Additional procedures yielded better results. The purpose of the proposed flow-chart is to evaluate the influence of dementia or dystonia as the cause of TMJ dislocation. These pathologies may be a cause of disease or recurrent dislocation. No relationship allows any surgical options to be performed. The flow-chart needs to be verified in the near future.
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  • Kenichi KURITA
    2016 Volume 28 Issue 1 Pages 22-27
    Published: April 20, 2016
    Released on J-STAGE: May 23, 2016
    JOURNAL FREE ACCESS
    Recurrent and habitual mandibular dislocation has increased in aging societies, especially in Japan. Non-surgical treatments using an elastic bandage or chin cap are initially indicated. However, it is difficult to continue these non-surgical treatments for long periods, because the materials often cause facial ulcer formation. Surgical therapy is usually considered for mandibular dislocations when conservative treatments have failed. However, most surgical treatments are too invasive for elderly patients. At present, there are no appropriate non-surgical and surgical treatments for elderly patients. We have developed a new cap to prevent mandibular dislocation as a non-surgical treatment and a new surgical plate for implantation into the mandibular eminence to block condylar dislocation. Both treatments are less invasive, secure, and safe for elderly patients compared with previous treatments.
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case report
  • Namiaki TAKAHARA, Satoshi NAKAGAWA, Kanako SUMIKURA, Hideki IMAI, Hiro ...
    2016 Volume 28 Issue 1 Pages 28-34
    Published: April 20, 2016
    Released on J-STAGE: May 23, 2016
    JOURNAL FREE ACCESS
    We report our clinical experience with three cases of temporomandibular joint (TMJ) ankylosis resulting from condylar fractures. Case 1 was a 42-year-old male involved in a traffic accident presenting with mandibular fractures: bilateral lateral dislocation of the mandibular condyles with a sagittal fracture and a parasymphyseal fracture resulting in inter-ramus width widening. The parasymphyseal fracture was treated by open reduction; the bilateral condylar fractures were treated conservatively. One year after the accident, he visited our department because of trismus. Bilateral TMJ ankylosis was diagnosed. Gap arthroplasty, coronoidectomy, and interpositional grafting with temporalis muscle flap were performed. The maximum mouth opening was 42 mm with no recurrence 1 year postoperatively. Case 2 was a 35-year-old female with left subcondylar, coronoid, and parasymphyseal fractures. The treatment of the fracture was the same as that for Case 1. Two years later, bilateral TMJ ankylosis was diagnosed. Osteoarthrotomy was performed. The maximum mouth opening was 40 mm with no recurrence one and a half years postoperatively. Case 3 was a 28-year-old female with right condylar head and symphyseal fractures. Open reduction and internal fixation were performed. One and a half years later, right TMJ ankylosis was diagnosed. Osteoarthrotomy was performed. The maximum mouth opening was 45 mm with no recurrence 8 years postoperatively. When treating condylar fractures, it is necessary to consider the risk of post-traumatic sequelae such as TMJ ankylosis.
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  • Yui MORI, Kenji KAKUDO, Noriko SUNADA, Masahiro WATANABE, Motohiro GOT ...
    2016 Volume 28 Issue 1 Pages 35-42
    Published: April 20, 2016
    Released on J-STAGE: May 23, 2016
    JOURNAL FREE ACCESS
    The patient was a 15-year-old female, who visited our hospital in March 2000 with the chief complaints of bilateral temporomandibular joint pain and lock during mouth-opening. At the first examination, the forced mouth-opening distance was 43 mm, and anterior open bite was noted. The patient had no medical history of note. MR findings at the first examination showed bilateral anterior disc displacement without reduction, condylar erosion, and joint effusion on both sides. The symptom of intermittent lock disappeared after treatment with a mandibular stabilization-type splint between May 2000 and May 2002. In 2003, preoperative orthodontic treatment was initiated. Sagittal splitting ramus osteotomy was performed in February 2005 and the postoperative course was good. MR image findings revealed that double contour had occurred during splint therapy, and the condylar erosion disappeared. After surgery, osseous changes were gradually observed on both condyles; the condylar bone marrow signal had decreased at four years after surgery, and progression of the condylar bone resorption stopped at five years after surgery. Six years after surgery, the condylar bone marrow signal gradually increased. As a result of sagittal splitting ramus osteotomy, the molar occlusal condition was stabilized, the condylar sliding movement improved, and the bone marrow signal increased during the long-term observation. The present mouth-opening distance is 40 mm with appropriate occlusion, and the clinical course has been favorable without temporomandibular joint or muscle pain.
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