Transport distraction versus costochondral graft for reconstruction of temporomandibular joint ankylosis: which is better?

OBJECTIVE This study compared the methods of transport distraction and costochondral graft in reconstruction of temporomandibular joint (TMJ) ankylosis. STUDY DESIGN Bilateral bony TMJ ankylosis was induced in 12 adult goats. Transport distraction of the mandibular ramus was performed on one side, whereas costochondral graft was performed on the other side. Jaw movements, TMJ healing, condylar remodeling, and recurrence of ankylosis were assessed by clinical, radiological, and histological examinations. RESULTS Both transport distraction and costochondral graft established a neo-condyle separating from the pseudo-disc with a joint space. The ankylosis scores were higher in the distraction side in the first 12 weeks. Both techniques showed no significant difference in the calcification scores and recurrence of ankylosis in the long term. The maximal jaw movements in 3 directions returned to the pre-ankylosis stage by both methods. CONCLUSIONS Distraction osteogenesis is an effective reconstruction method for TMJ ankylosis, matching the gold standard of costochondral grafting.

[1]  C. Friedman,et al.  Experimental mandibular regrowth by distraction osteogenesis. Long-term results. , 1993, Archives of otolaryngology--head & neck surgery.

[2]  Ilizarov Ga,et al.  The principles of the Ilizarov method. , 1988 .

[3]  K. Nakagawa,et al.  A model for temporomandibular joint disc repositioning surgery. , 2001, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[4]  John Lo,et al.  The Long-Term Effect of Transport Distraction in the Management of Temporomandibular Joint Ankylosis , 2007, Plastic and reconstructive surgery.

[5]  Jing Hu,et al.  Growth of the Mandible after Condylar Reconstruction Using Transport Distraction Osteogenesis: An Experimental Investigation in Goats , 2008, Plastic and reconstructive surgery.

[6]  T Takato,et al.  Experimental study of reconstruction of the temporomandibular joint using a bone transport technique. , 2000, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[7]  Experimentally induced ankylosis and facial asymmetry in the macaque monkey. , 1981, Journal of maxillofacial surgery.

[8]  K. Su-Gwan.  Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. , 2001, International journal of oral and maxillofacial surgery.

[9]  B. Moffett,et al.  Condylar trauma and facial asymmetry: an experimental study. , 1980, Journal of maxillofacial surgery.

[10]  W. Ehler,et al.  A comparison of the form and function of the human, monkey, and goat temporomandibular joint. , 1994, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[11]  S U Stucki-McCormick,et al.  Reconstruction of a neocondyle using transport distraction osteogenesis. , 1999, Seminars in orthodontics.

[12]  K. Kurita,et al.  The effect of autogenous costochondral grafts on temporomandibular joint fibrous and bony ankylosis: A preliminary experimental study. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  S U Stucki-McCormick,et al.  Reconstruction of the Mandibular Condyle Using Transport Distraction Osteogenesis , 1997, The Journal of craniofacial surgery.

[14]  H. Schwartz,et al.  Distraction osteogenesis for temporomandibular joint reconstruction. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[15]  L. Cheung,et al.  Surgical induction of temporomandibular joint ankylosis: an animal model. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  Jing Hu,et al.  Reconstruction of mandibular condyle by transport distraction osteogenesis: Experimental study in rhesus monkey. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[17]  A. Goss,et al.  The sheep as a model for temporomandibular joint surgery. , 1987, International journal of oral and maxillofacial surgery.

[18]  P. Mariani,et al.  Temporomandibular joint ankylosis: report of 14 cases. , 2003, International journal of oral and maxillofacial surgery.

[19]  K. Kurita,et al.  The effect of gap arthroplasty on temporomandibular joint ankylosis: an experimental study. , 2001, International journal of oral and maxillofacial surgery.

[20]  B. Ulusal,et al.  The Role of Trauma on Temporomandibular Joint Ankylosis and Mandibular Growth Retardation: An Experimental Study , 2004, The Journal of craniofacial surgery.

[21]  T. Muto,et al.  Histologic study of synovitis induced by trauma to the rat temporomandibular joint. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[22]  R. MacIntosh,et al.  The use of autogenous tissues for temporomandibular joint reconstruction. , 2000, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[23]  K. Kurita,et al.  A sheep model for temporomandibular joint ankylosis. , 1999, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[24]  A. Darwazeh,et al.  Experimental induction of rheumatoid arthritis in temporomandibular joint of the guinea pig: a clinical and radiographic study. , 2000, Dento maxillo facial radiology.