Extensive temporomandibular joint ankylosis involving medial pterygoid plates and the maxillary tuberosity- a case report

Multidetector computed tomography in preoperative planning for temporomandibular joint ankylosis: A pictorial review and proposed structured reporting format

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

Use of Lasers and Piezoelectric in Intraoral Surgery

Laser therapy has been delivering good results for more than 30 years. Therapeutic effects are seen due to its ability to stimulate cell proliferation, revascularization, cell regeneration, local microcirculation, and vascular permeability; leading to edema reduction and analgesic effects. The piezoelectric system has been used in several surgeries recently, following the trend of minimally invasive surgery. The system consists of crystals undergoing deformation when exposed to electric current, resulting in an oscillating movement with ultrasound frequency. In oral surgery it is used in orthognathic and temporomandibular joint procedures, alveolar corticotomies, tumor excision, bone grafts, third molars, and dental implants.