Clinical Research Directory

Comparison of Three Osteotomy Techniques in Temporomandibular Joint Ankylosis Surgery

Temporomandibular joint (TMJ) ankylosis is a condition in which the jaw joint becomes partially or completely fused, resulting in restricted mouth opening and difficulties with chewing, speaking, and daily activities. Surgical treatment aims to remove the ankylotic bone and restore normal jaw movement. Different bone-cutting devices can be used during surgery, but their effects on surgical efficiency, postoperative recovery, and quality of life may vary. This prospective, non-randomized comparative clinical study aimed to compare three osteotomy techniques used in TMJ ankylosis surgery: piezoelectric surgery, an ultrasonic bone scalpel, and a conventional reciprocating saw. A total of 32 patients undergoing TMJ ankylosis surgery were included. Eleven patients underwent surgery using a piezoelectric device, eleven using an ultrasonic bone scalpel, and ten using a conventional reciprocating saw. All surgical procedures were performed by the same surgeon under general anesthesia using a standardized surgical protocol. The primary outcome was osteotomy time, measured during surgery. Secondary outcomes included total operative time, intraoperative blood loss, maximum mouth opening, postoperative pain, facial nerve function, and patient-reported quality of life. Facial nerve function was evaluated using the House-Brackmann grading system and the Sunnybrook Facial Grading System. Quality of life was assessed using the SF-12, WHOQOL-BREF, OHIP-14, and UW-QOL questionnaires. Patients were followed for six months after surgery to evaluate functional recovery and changes in quality of life. The study aimed to determine whether the choice of osteotomy device was associated with differences in surgical efficiency, early postoperative recovery, and patient-reported outcomes.

Virtual Planning of Total Temporomandibular Joint Replacement

A total TMJ replacement surgery is currently planned based on the X-ray appearance of the facial X-ray. It is now possible to use either an individually designed TMJ prosthesis or a prosthesis with a standard appearance. It is a significantly higher cost for treatment with an individually manufactured prosthesis, but it also provides the opportunity for virtual planning of the positioning of the jaws and prosthesis. By using a planning program with treatment simulation through the use of our own virtual models for standard prostheses, virtual planning of jaw and prosthesis positioning is possible even with a standardized temporomandibular joint prosthesis. In this way, the advantages of virtual planning are partly brought to the patients at a much lower price. This project aims to virtually plan treatment for patients with standardized temporomandibular joint prosthesis. Patients eligible for this study are included retrospectively (have already been treated). Their X-rays will be used for treatment planning and for comparison with the treatment outcome of previous TMJ treatment. The study will analyze the possibilities of the standardized prostheses to provide the same positions, temporomandibular joint replacements and movements of the jaw as an individual temporomandibular joint prosthesis has. This is done by measuring the planned positions of standardized temporomandibular joint prostheses compared to the treatment outcome shown by previous postoperative X-ray examinations. The study aims to clarify the possibilities of a simpler and less expensive technology, standardized temporomandibular joint prostheses, to achieve the same good treatment outcome as a more costly technology. This with the same possibilities for treatment planning and use that the existing, more expensive technology, individual temporomandibular joint prostheses, has today.

Patient-Specific Guides for Gap Pediatric Arthroplasty

To date, few reports have combined patient-specific guides with piezoelectric devices for gap arthroplasty in children. This study evaluates the feasibility, accuracy, and early outcomes of this approach, hypothesizing that the combination of narrow-slit surgical guides and piezoelectric osteotomy provides safe and reproducible results in pediatric TMJ ankylosis.