Uso de la tomografía computarizada en el diagnóstico de la anquilosis de la articulación temporomandibular: presentación de dos casos clínicos

Medicina oral, patologia oral y cirugia bucal (Impact Factor: 1.1). 01/2006;
Source: OAI

ABSTRACT Ankylosis of the temporomandibular joint is characterized by restriction or limitation of mandibular movement. It presents as a classic symptom a limited range of motion on opening. Radiographically, ankylosis presents features that facilitate the diagnosis. However, its visualization is not clear in most of the cases involving conventional radiographic techniques. With the evolution of radiographic techniques, computed tomography (CT) became an important examination in the diagnosis of the ankylosis of temporomandibular joint. Due to the increasing use of the CT and its importance in the diagnosis of this disease, the aim of this paper is to present and describe tomographic images of ankylosis of this joint by presenting two clinical cases, using several slices as axial, coronal, and three-dimensional reformatted images. La anquilosis de la articulación temporomandibular es definida como la abolición o limitación de los movimientos de dicha articulación. Radiográficamente la anquilosis demuestra aspectos bien característicos que facilitan el diagnóstico, sin embargo, su análisis en las técnicas radiográficas convencionales, en la mayoría de las veces, no se presenta de forma clara. Con la evolución de las técnicas radiográficas, la tomografía computarizada pasó a ser un examen de gran importancia en el diagnóstico de las anquilosis temporomandibulares. En vista de ello, el presente trabajo se propone mostrar y describir imágenes tomográficas de la anquilosis de esta articulación, presentando dos casos clínicos, utilizando diversos planos, como el axial y el coronal, además del uso de la reconstrucción sagital y en 3D, con la finalidad de orientar una correcta indicación e interpretación de este examen, el cual representa una valiosa herramienta para los profesionales de la Odontología.

Download full-text


Available from: Francisco Haiter-Neto, Jul 06, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: The authors present a review of 14 patients with temporomandibular joint ankylosis treated between March 1992 and February 1997. Etiology of the ankylosis was trauma in four patients, ear infection in two, systemic infection in one case, congenital in another, and unknown in six. Patients were divided into two groups, according to their age: 16 years and under and over 16 years of age. The basic principle of surgical treatment in both groups is ample access for osseous resection and coronoidectomy. Costochondral grafts were used in group one (nine patients), while interposition of a silicone block, was performed in the second group (five patients). Follow-up evaluations were from twelve to 53 months (average 28.2 months). One case of recurrence occurred in the first group and no recurrences in the second group. The average long-term mouth opening in both groups was 32.8 mm.
    International Journal of Oral and Maxillofacial Surgery 03/2003; 32(1):24-9. DOI:10.1054/ijom.2002.0308 · 1.36 Impact Factor
  • Journal of Dentistry 04/1995; 23(2):129-129. DOI:10.1016/0300-5712(95)90048-9 · 2.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Roentgenographic examination has long been a useful diagnostic tool for temporo-mandibular joint (TMJ) disease. The methods include TMJ tomography, panoramic radiography and computerized tomography (CT) scan with or without injection of contrast media. Recently, three-dimensional CT (3D-CT), reconstructed from the two-dimensional image of a CT scan to simulate the soft tissue or bony structure of the real target, was proposed. In this report, a case of TMJ ankylosis due to traumatic injury is presented. 3D-CT was employed as one of the presurgical roentgenographic diagnostic tools. The conventional radiographic examination including panoramic radiography and tomography showed lesions in both sides of the mandible. CT scanning further suggested that the right-sided lesion was more severe than that on the left. With 3D-CT image reconstruction the size and extent of the lesions were clearly observable. The decision was made to proceed with an initial surgical approach on the right side. With condylectomy and condylar replacement using an autogenous costochondral graft on the right side, the range of mouth opening improved significantly. In this case report, 3D-CT demonstrates its advantages as a tool for the correct and precise diagnosis of TMJ ankylosis.
    Zhonghua yi xue za zhi = Chinese medical journal; Free China ed 05/1999; 62(4):244-9.