Preface: Temporomandibular Joint Surgery: Fascinating but Tackling Difficulties xi
Florencio Monje
Magnetic Resonance Imaging of the Temporomandibular Joint: Key Point in the Election of Treatment 129
José M. López-Arcas, David González-Ballester, José L. Del Castillo, Elena Salvador
Introduction 129
Radiological anatomy 129
Temporomandibular joint MRI protocol 129
Temporomandibular joint pathology: findings in MRI 130
Temporomandibular joint MRI safety issues 133
Clinics care points 135
Athrocentesis: What, When, and Why? 137
Dorrit W. Nitzan, Hadas Lehman Naaman
Arthrocentesis technique 137
Arthrocentesis—Mode of action 139
The role of arthrocentesis in various temporomandibular joint disorders 140
Clicking joint 140
Limited mouth opening 141
Open lock versus temporomandibular joint condylar dislocation 142
Osteoarthritis 142
Other inflammatory diseases, hemarthrosis, and infection 143
Clinics care points 143
Disclosure 143
Usual and Nonusual Findings in Temporomandibular Joint Arthroscopy 147
Reem H. Hossameldin
Introduction 147
Content 147
Summary 156
Clinics care points 157
Lysis and Lavage: What Else in Temporomandibular Joint Surgery? 159
Manuel Moreno-Sánchez, Florencio Monje
Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
Introduction 159
Surgical technique 159
Patient position 159
Preparation 159
Surgical approach 159
Surgical procedure 160
Potential complications 161
Clinical results in the literature 162
Summary 164
Clinics care points 164
Disclosure 164
Temporomandibular Joint Arthroscopic Surgical Techniques: Electrocoagulation and Myotomy Indications 165
Fernández Sanromán Jacinto, Sembronio Salvatore
Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
Surgical indications 166
Synovitis 166
Adhesions 166
Disc Mobilization 166
Disc Perforations 166
Bone pathologies 169
Synovial chondromatosis 169
Joint Hypermobility 169
Complications 172
Clinics care points 172
Disclosure 172
Arthroscopic Disc Repositioning Techniques of the Temporomandibular Joint: Part 1: Sutures 175
Raúl González-García, Rafael Martín-Granizo
Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
Introduction 175
Surgical technique 176
Preoperative planning 176
Preparation and patient positioning 176
Surgical approach 176
Surgical procedure 176
Unique suture 177
Posterior traction suture 177
Rotating curved suturing tip 179
Double-pass suture 179
Double suture 179
Potential complications 181
“Pearls and pitfalls” 181
Immediate postoperative care, rehabilitation, and recovery 181
Clinical results in the literature 182
Summary 182
Clinics care points 182
Arthroscopic Disc Repositioning Techniques of the Temporomandibular Joint Part 2: Resorbable Pins 185
Rafael Martín-Granizo, Raúl González-García
Introduction 185
Surgical technique 185
Preoperative Planning 185
Preparation and Patient Positioning 186
Surgical Approach 186
Surgical Procedure 186
Advantages and disadvantages 187
Potential Complications 187
“Pearls and Pitfals” 188
Immediate postoperative care, rehabilitation, and recovery 189
Clinical results in the literature 190
Summary 191
Temporomandibular Joint Surgery: Open Discopexy and “Functional Arthroplasty” 193
Piero Cascone, Fabrizio Spallaccia, Valentino Vellone
Introduction 193
Surgical technique 193
Preoperative planning 193
Prep and patient positioning 193
Surgical approach 194
Surgical procedure 194
Potential complications 195
Pearls 196
Pitfalls 197
Immediate postoperative care 197
Rehabilitation and recovery 197
Clinics care points 197
Disclosure 198
Open Temporomandibular Joint Surgery: Discectomy with or Without Interpositional Reconstruction? 199
Andrew J. Sidebottom
Introduction 199
Outcomes following discectomy with NO interposition 199
Outcomes following discectomy WITH interposition 200
Proplast-Teflon 200
Silicone 200
Fossa hemi-arthroplasty 200
Temporalis myofascial graft 201
Auricular cartilage 201
Free fat 202
Dermis-fat graft 202
Summary 202
Clinics care points 203
Conflict of interest 203
Unilateral Condylar Hyperactivity: Condylectomy or More? 205
Laura Villanueva-Alcojol, Alberto Cuevas Queipo de Llano, Carrol Saridin
Introduction 205
Epidemiology 205
Cause 205
Classification 205
Diagnosis 206
Histology 206
Treatment 206
Surgical technique 209
Preoperative planning 209
Surgical approach 209
Postoperative care: rehabilitation and recovery 210
Clinics care points 215
Autogenous Reconstruction of the Temporomandibular Joint 217
Nadeem R. Saeed, Barbara Gerber
Introduction 217
Methods of autogenous (biological) reconstruction 217
Gap/interpositional arthroplasty 217
Vascularized grafts 218
Nonvascularized Grafts 218
Advantages and Disadvantages of Autogenous Grafts 221
Summary 221
Clinics care points 221
Disclosure 221
Alloplastic Reconstruction of the Temporomandibular Joint in Patients with Dentofacial Deformities 223
Gary Warburton, Louis G. Mercuri
Introduction: nature of the problem 223
Preoperative planning 223
Temporomandibular joint alloplastic device selection and design 223
Virtual surgical planning 223
Sequencing combined temporomandibular joint reconstruction and orthognathic surgery 225
Surgical preparation in the operating room 226
Surgical approaches and implantation procedure 227
Surgical access 227
Condylectomies and coronoidectomies 227
Setting the occlusion into the intermediate splint 227
Implantation of the alloplastic devices 228
Closure of the surgical sites 228
Maxillary orthognathic surgery and genioplasty, if needed 230
Rehabilitation and recovery 230
Pearls and pitfalls 231
Clinical cases 233
Summary 233
Clinics care points 233
Tissue Engineering in Temporomandibular Joint Reconstruction 235
David Faustino Ângelo, Florencio Monje
Introduction 235
Animal model for temporomandibular joint tissue engineering 235
Study design for preclinical temporomandibular joint tissue engineering 236
The rationale for temporomandibular joint tissue engineering 238
Tissue-engineered implants 239
Summary 244
Clinics care points 244
Disclosure 244
Funding 244
Physiotherapy in the Postoperative Period of Temporomandibular Joint Surgery 247
Alfonso Gil-Martínez, Josué Fernández-Carnero, Susan Armijo-Olivo
Introduction 247
Physiologic impact of the surgery related to physical therapy management 247
Indications/contraindications for physical therapy 247
Beginning and end of physiotherapy treatments 248
Physiotherapy approaches 248
Immediate postsurgical period 248
Techniques based on the representation of movement 248
Lymphatic drainage 248
Postsurgical thermotherapy (cryotherapy) 249
Limitation of mobility 249
Alteration of motor control and instability 250
Hypoalgesic techniques 250
Therapeutic patient education 251
Neurophysiology 251
Advertisements/information 252
Self-management 252
Referral 254
Summary 254
Clinics care points254
