Temporomandibular Joint Dysplasia in Cranio-Maxillofacial Dysplasia: A Retrospective Study. Guideline Treatment Proposal.
Temporomandibular Joint Dysplasia in Cranio-Maxillofacial Dysplasia: A Retrospective Study. Guideline Treatment Proposal.
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DOI：
10.1097/scs.0000000000007049
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发表时间：
2021-05-01
期刊：
影响因子：
--
通讯作者：
Nicot R
中科院分区：
文献类型：
--
作者：
Ferri J;Schlund M;Touzet-Roumazeille S;Sciote JJ;Nicot R
颅颌面发育不良（CMD），包括颅面小畸形、综合征（如Treacher Collins或Williams）和孤立的髁-下颌发育不良，是一个有争议的话题，治疗方法和诊断分类多种多样。作者在此回顾性研究了85例由这三种主要类型的CMD引起的先天性髁突发育不良患者，采用不同的技术治疗，旨在使面部骨骼和咬合正常化。作者回顾性研究了85例患者，年龄从3岁到53岁，受不同类型CMD的影响。治疗方案包括：肋软骨移植、正颌手术、牵张成骨手术、正畸和牙面矫形治疗以及软组织手术。结果由手术小组评估。17例患者行肋软骨移植术，14例行牵张成骨术，17例行正畸牙面矫形术，45例行正颌手术。作者没有进行任何神经移植或颞下颌关节假体置入。51例患者预后良好，10例预后良好，9例预后较差，2例预后较差，14例预后不详。可以提出几种不同的CMD处理方法。作者认为，儿童重大缺损由于其生长潜力大，应行肋软骨移植术，轻微缺损应首先尝试矫形治疗。牵张成骨应保留在骨科治疗后反应不佳或肋软骨移植生长不全的病例。为了获得良好的结果，在生长末期通常需要进行正颌手术。颞下颌关节假体应保留在极端情况下。
Cranio-Maxillofacial Dysplasias (CMD), including Craniofacial Microsomias, syndromes (such as Treacher Collins or Williams) and isolated Condylo-Mandibulo-Dysplasia, is a controversial subject with treatments as diverse as diagnostic classifications. The authors present here a retrospective study of 85 patients, with congenital condyle dysplasia arising from these 3 main types of CMD, treated with different techniques that aimed to normalize the facial skeleton and occlusion. The authors studied retrospectively 85 patients, aged from 3 to 53 years old, affected by different types of CMD. Treatment options included: costochondral grafts, orthognathic surgeries, distraction osteogenesis procedures, orthodontic and dentofacial orthopedic treatments, and soft tissues surgeries. Outcomes were evaluated by the surgical team. Seventeen patients were treated with costochondral grafting, 14 with distraction osteogenesis, 17 with orthodontic and dentofacial orthopedic, and 45 with orthognathic surgery. The authors did not perform any nerve grafting or temporomandibular joints prosthesis placement. Fifty-one patients presented an excellent result, 10 a good result, 9 a poor result, 2 a bad result, and 14 an unknown result. Several different treatments of CMD can be proposed. The authors think that major defect in children should undergo costochondral grafting because of its growth potential while in case of minor defect, orthopedic treatment should be tried in the first place. Distraction osteogenesis should be reserved for cases with poor response after orthopedic treatment or growth insufficiency with costochondral grafting. Orthognathic surgery is often necessary at the end of the growth period to obtain an excellent result. Temporomandibular joints prosthesis should be reserved for extreme cases.
影响因子：
2.7
作者：
Liu X;Zhang Y;Wang S;Lei Z;Li X;Fan D
通讯作者：
Fan D