Assessment of patient-specific titanium onlay versus autogenous inlay eminoplasty technique for treatment of recurrent t
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ORIGINAL ARTICLE
Assessment of patient-specific titanium onlay versus autogenous inlay eminoplasty technique for treatment of recurrent temporomandibular joint dislocation: a randomized clinical trial Rania Ihab 1 & Ragia Mounir 2 & Sherif Ali 2 & Mohamed Mounir 2 Received: 23 April 2020 / Accepted: 29 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Various procedures have been adopted for eminence augmentation for treatment of recurrent temporomandibular joint dislocation. The aim of this study is to assess maximal incisal opening (MIO) using a custom-made titanium implant versus inlay autogenous augmentation from the patient’s chin for more stable condylar movements. Methods Ten patients were treated in this study (20 joints) five patients with bilateral patient-specific titanium onlay implant and five for autogenous inlay grafting technique; each implant in the study group was virtually designed using a specific software and milled from titanium grade V blocks, then fixed with mini screws at the lateral aspect of the zygomatic arch while in the control group, autogenous corticocancellous bone block was harvested from the chin and wedged at the created defect of the eminence to increase its height. Results The follow-up period ranged from 6 months to 1 year to access the maximal incisal opening (MIO). The mean preoperative maximal incisal opening was 47.8 mm and that of the postoperative was 33.2 mm in the study group and 35.4 mm in the control group, respectively. One patient reported postoperative slight unilateral edema and pain that gradually diminishes after 1 month postoperative. Conclusion No statistical difference between both groups p value 0.3. Keywords Temporomandibular joint . Dislocation . Computer guided . Patient-specific . Eminoplasty . Inlay
Introduction Recurrent condylar dislocation (RCD) of the temporomandibular joint (TMJ) is an uncommon incidence. The main cause of such condition depends mainly onsudden anatomic alteration in either joint soft tissue as laxity of ligaments, capsule, and muscles or bony component as condylar head and eminence. Also, disturbance in the relation between the mandibular condyle and the articular eminence and some arthritic diseases could be another cause * Mohamed Mounir Ragia Mounir [email protected]; [email protected] 1
Oral and Maxillofacial Surgery Department, MSA University, 6th of October, Egypt
2
Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, 12 saray el manial street, El Manial, Cairo, Egypt
of anterior condylar dislocation. Various treatment modalities have been introduced in the literature starting either from conservative treatment as intermaxillary fixation, injection of sclerosing agents, or intra articular surgical management to limit the condylar path hypermobility. The selection of the proposed treatment protocol is still a debated issue [1], as most of the surgical protocols used previously for treatment of condylar dislocation showed either donor site morbidity, prolong
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