Temporomandibular Disorder
Conditions
Brief summary
Temporomandibular joint internal derangement (TMJ ID) is the most frequent type of temporomandibular disorder (TMDs)which is managed by different therapeutic modalities. it begins with conservative methods like medical treatment, physiotherapy, thermotherapy, and bites appliance therapy. Surgical intervention is a controversial issue in cases not responding to conservative methods. A novel minimally invasive surgical technique which is extracapsular trans oral (Pterygomaxillary disjunction) has been advocated as a minimally invasive extracapsular technique that preserves TMJ integrity.
Interventions
PROCEDUREPterygomaxillary disjunction with interposition Y-shape plate
All patients will be treated under general anesthesia. The pterygoid plate will be fractured, pried up, and pushed backward. A Y-shape plate will be fixed to the lateral maxillary surface with its vertical limb and the other two limbs are turned to fit into the retro maxillary space preventing the reattachment of the fractured pterygoid plate
Sponsors
Hams Hamed Abdelrahman
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Patients without relevant disease * Patients refractory to conservative treatment \> 6 months. * Patients are diagnosed, with unilateral/bilateral anterior disc displacement without reduction, clinically and by MRI recently. * No previous TMJ surgery. * No previous maxillofacial trauma.
Exclusion criteria
* Patients with systemic joint disease (rheumatoid, osteoarthritis, gouts). * Medically compromised patients contraindicating operation. * Patients to whom general anesthesia is contraindicated. * Patient with neuromuscular disorders. * Patients with any gross pathology of the ear. * Patient with psychoneurotic disorders.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in wound healing | 1st week and 2nd week | The sutured wounds will be examined after one and two weeks for signs and symptoms of infection including swelling, redness, hotness, pus discharge, and pain in addition to observation for any manifestations of wound healing disturbance, as wound dehiscence and hardware exposure. |
| Change in TMJ clinical dysfunction | 1st week, 2nd week, 1 month, and 3 months | Helkimo's dysfunction index is used, including the interincisal opening of the mandible, deviation during the opening, dysfunction of TMJ, pain in the TMJ and preauricular region, and also masticatory muscles were palpated for pain during the follow-up periods. |
| disc position | at 3 months | MRI assessment by proton-density (PD), Evaluation by MRI will be done after 3 months to assure disc position. |
Countries
Egypt
Outcome results
None listed