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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Temporomandibular joint anchorage surgery: a 5-year follow-up study
Xiuming Liu1, Zhihang Zhou1, Yi Mao1
1Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
Abstract:
The purpose of this study was to confirm the 5-year efficiency of temporomandibular joint (TMJ) anchorage, using clinical evaluation and magnetic resonance imaging (MRI). We also studied the influence of disc length and position on efficiency and postoperative condylar height. Sixty-one patients (76 joints) undergoing TMJ disc anchorage were followed up for >5 years. Visual analogue scale (VAS) score and maximum mouth-opening pre-and postsurgery were analysed and patient satisfaction recorded. Disc length, condyle height and disc position pre- and postsurgery were measured using MRI. Patients were ranked as A, B or C degree according to postoperative disc condyle position. Mean follow-up time was 71.34 months. Maximum mouth-opening improved by 14.34 ± 5.87 mm, and VAS score decreased by 33.44 ± 20.56 (P < 0.05). Clinical evaluation efficiency was 84.21%; patient satisfaction rate was 85.53%. On follow-up MRI, 68 joints were judged A or B degree (89.67%). Disc length was 7.96 ± 1.38 mm, 7.10 ± 1.41 mm and 5.75 ± 1.16 mm in A, B and C groups, respectively. In patients evaluated as C, condylar height decreased by 0.43 ± 1.36 mm, while increasing by 0.67 ± 1.88 mm and 0.51 ± 1.09 mm in A and B groups, respectively (all P < 0.05). We concluded that anchorage surgery improves mouth-opening and eliminates pain, longer disc length is related to better postoperative disc position, and significant condylar reconstruction occurs after disc repositioning. MRI confirmed that TMJ disc anchorage is reliable 5 years postsurgery.

