We analyzed and presented the results of treatment of children with bilateral ankylosis of the TMJ using the method of distraction osteogenesis.
Treatment of bilateral ankylosing diseases is extremely important today.
Objective: The aim of our study is to improve the treatment of children with bilateral ankylosing diseases using distraction osteogenesis.
Materials and methods: From 2010 to 2018, surgical treatment of 75 children and adolescents with a diagnosis of Bilateral Ankylosis of the temporomandibular joint was performed in the department of the CLH dental children's, clinical center of maxillofacial reconstructive and plastic surgery. After a comprehensive examination of children, surgical treatment was carried out. 77 surgical operations of “Ostemetium of the mandible branch with the distraction apparatus in the region of the mandible branch” were performed. In order to select the device, children made a stereolithographic model to study the size of the branch and body of the mandible in order to select the distraction apparatus and plan the guidelines for the osteotomy line, the position of the apparatus relative to the body and the mandible branch, determine the distraction vector and its subsequent size. 79% (61 children) a CONMET distraction device was installed. Another group of children, 21% of children (16 children), were installed a distraction device of the brand DePuy Synthes, Curvilinear distraction curvilinear DiPui Synthesis.
After the retention period, the DA was removed. After increasing the size of the branches of the lower jaw, the active phase of orthodontic treatment was carried out on a non-removable bracketing system.
Results and discussion: From 2010-2018, 77 patients with a diagnosis of bilateral ankylosis of the TMJ, with a good functional and aesthetic effect, were fully treated. The distraction method allows you to adjust the linear parameters of the mandible, increases and changes the position of the mandible. In the treatment of bilateral lesions of the TMJ, the advantage is the simultaneous elongation of the lower jaw in two planes, the correct position of the chin. The convenience of this method is indisputable, since it can be used in all periods of childhood with certain indications (differences in pace and magnitude of distraction). The distraction method is included in the compulsory treatment algorithm developed for children with bilateral and unilateral ankilotic lesions of the temporomandibular joint. treatment of all patients with this pathology.
Conclusions: Treatment of the pathology of bilateral ankylosis of the TMJ requires a long and complex treatment using distraction osteogenesis. This method is quite simple for the doctor of maxillofacial surgeon and for the child, it is also universal for different age groups of children and adolescents undergoing surgical treatment using distraction osteogenesis.
Literature
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