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Hypothesis：Computer-aided design virtual mandibular position is feasible for costochondral graft growing and occlusion stabilizing in the one-stage treatment of children temporomandibular joint ankylosis (TMJA) or condyle absence with jaw deformity.
Methods: The inclusion criteria is children patients younger than 12 years old with unilateral TMJA or condyle absence. A virtual mandibular position is designed preoperatively according to the CT data of jaw and dentition. 3D printed templates and occlusal splints are used to guide the costochondral graft and mandibular position. During surgery, the affected ramus is reconstructed with costochondral grafting under the virtual mandibular position. After surgery, the occlusal splint is fixed to maxilla at least one month, and then, replaced by orthodontic functional appliance to promote downward growth of the maxilla. Occlusion, facial symmetry, costochondral graft growing would be evaluated and analysed until adulthood.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Children TMJA or condyle absence with Jaw Deformity | inclusion criteria: <12 years old; Unilateral temporomandibular joint ankylosis or condyle absenceï¼› Temporomandibular joint reconstructed with costochondral graftï¼› |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| temporomandibular jont reconstruction with costochondral transplantation | Procedure | temporomandibular jont reconstruction with costochondral transplantation guided by virtual mandibular position |
| Measure | Description | Time Frame |
|---|---|---|
| Bilateral ramus height,chin deviation,maxilla height | Bilateral ramus height,chin deviation,maxilla height in millimeter. These measurements were accomplished by ProPlan 2.0( SynthesProPlan，Materialise，Belgium） | preoperation |
| Bilateral ramus height,chin deviation,maxilla height 6 months after operation | Bilateral ramus height,chin deviation,maxilla height in millimeter 6 months after operation. These measurements were accomplished by ProPlan 2.0( SynthesProPlan，Materialise，Belgium） | 6 months after operation |
| Bilateral ramus height,chin deviation,maxilla height 12 months after operation. | Bilateral ramus height,chin deviation,maxilla height in millimeter 12 months after operation.These measurements were accomplished by ProPlan 2.0( SynthesProPlan，Materialise，Belgium） | 12 months after operation |
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Inclusion Criteria:
Exclusion Criteria:
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Patients are surgically treated in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Shuo Chen, MD | Contact | +86 15910920699 | chenshuo-88@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Yi Zhang, PhD | Peking University Hospital of Stomatology | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Hospital of Stomatology | Recruiting | Beijing | Beijing Municipality | 100081 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21772189 | Background | Zhang X, Chen M, Wu Y, Wang B, Yang C. Management of temporomandibular joint ankylosis associated with mandibular asymmetry in infancy. J Craniofac Surg. 2011 Jul;22(4):1316-9. doi: 10.1097/SCS.0b013e31821c9342. | |
| 2213309 | Background | Kaban LB, Perrott DH, Fisher K. A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg. 1990 Nov;48(11):1145-51; discussion 1152. doi: 10.1016/0278-2391(90)90529-b. |
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The data was published 6 months at the end of the trial, through the form of paper publication
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| 19686936 | Background | Kaban LB, Bouchard C, Troulis MJ. A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg. 2009 Sep;67(9):1966-78. doi: 10.1016/j.joms.2009.03.071. |
| 7699266 | Background | Perrott DH, Umeda H, Kaban LB. Costochondral graft construction/reconstruction of the ramus/condyle unit: long-term follow-up. Int J Oral Maxillofac Surg. 1994 Dec;23(6 Pt 1):321-8. doi: 10.1016/s0901-5027(05)80046-3. |
| 9461132 | Background | Padwa BL, Mulliken JB, Maghen A, Kaban LB. Midfacial growth after costochondral graft construction of the mandibular ramus in hemifacial microsomia. J Oral Maxillofac Surg. 1998 Feb;56(2):122-7; discussion 127-8. doi: 10.1016/s0278-2391(98)90847-3. |
| 22117712 | Background | Zhu S, Li J, Luo E, Feng G, Ma Y, Hu J. Two-stage treatment protocol for management of temporomandibular joint ankylosis with secondary deformities in adults: our institution's experience. J Oral Maxillofac Surg. 2011 Dec;69(12):e565-72. doi: 10.1016/j.joms.2011.07.025. |
| 24613028 | Background | Lu C, Huang D, He D, Yang C, Yuan J. Digital occlusal splint for condylar reconstruction in children with temporomandibular joint ankylosis. J Oral Maxillofac Surg. 2014 Aug;72(8):1585-93. doi: 10.1016/j.joms.2013.12.033. Epub 2014 Jan 15. |
| ID | Term |
|---|---|
| C536957 | Temporomandibular ankylosis |
| D005146 | Facial Asymmetry |
| ID | Term |
|---|---|
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
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