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- W2088339936 abstract "Contemplating a recent conference where distraction osteogenesis was hotly criticized and fiercely defended during a debate, we are inspired to highlight a particular surgical indication where the philosophy of osteodistraction might offer benefits over conventional protocol. The hallmark of temporomandibular joint (TMJ) ankylosis is functional and esthetic disability. The restoration of oral opening in this condition is by osteoarthrectomy with interpositional arthroplasty using fascia of the temporalis muscle. 1 Tompach P. Dodson T.B. Kaban L.B. Autogenous temporomandibular joint replacement. in: Fonseca R.J. Bays R.A. Quinn P.D. Oral and Maxillofacial Surgery. vol 4. Saunders, Philadelphia2009: 301-315 Google Scholar Kaban also proposed reconstruction with a costochondral graft stabilized with fixation. This would restore the vertical height of the ramus of mandible, but the costochondral component, unlike a normal graft, would actively cause further growth of the mandible. The use of costochondral grafts has led to donor site morbidity and even failure because in a child the tendency for overgrowth of the mandible is unpredictable. 2 Guyuron B. Lasa Jr, Cl. Unpredictable growth pattern of costochondral graft. Plast Reconstr Surg. 1992; 90: 880 Crossref PubMed Scopus (191) Google Scholar TMJ prostheses have not demonstrated expected longevity or performance. 3 Schwartz H.C. Relle R.J. Distraction osteogenesis for temporomandibular joint reconstruction. J Oral Maxillofac Surg. 2008; 66: 718 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar In replyJournal of Oral and Maxillofacial SurgeryVol. 68Issue 3PreviewI welcome the opportunity to comment on the above letter regarding the protocol for management of temporomandibular joint (TMJ) ankylosis first published in the Journal in 1990.1 In this 7-step protocol, Kaban et al1 emphasized a conceptual approach for surgical management of ankylosis that included 1) complete excision of the ankylotic mass; 2) ipsilateral coronoidectomy; 3) contralateral coronoidectomy when necessary to achieve complete mobility; 4) lining of the TMJ with native disc, when possible, or a temporalis myofascial flap; 5) reconstruction of the ramus/condyle unit with a costochondral graft; 6) early mobilization of the jaw; and 7) aggressive physical therapy. Full-Text PDF" @default.
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- W2088339936 date "2010-03-01" @default.
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- W2088339936 title "Is a Modification of Kaban's Protocol in Treating Temporomandibular Joint Ankylosis Appropriate?" @default.
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