Mandibular growth and mouth opening after two different surgeries in TMJ ankylosis: a one-decade assessment

The long-term outcome and clinical results of gaparthro plasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. A nonrandomized, retrospective clinical study of 10 cases of condylar ankylosis [18 Joints] of the mandible surgically treated during a 12 year period from 1990 to 2002 was performed. Four patients were treated by condylectomy and interpositional Flap and Six patients were treated by condylectomy and immediate costachondral rib grafts. The First group underwent long-term postoperative therapy using removable activator appliances. Casts, radiagraphs, photographs, computed tomography [CT] Scans, were Used post surgically to evaluate rib graft, condylar growth and function, occlusion, and Facial and condylar symmetry. Symmetry, arch coordination, correction of occlusal canting, mandibular deviation, facial growth and prevention of reankylosis were obtained and better controlled in those cases that underwent long-tern or thodontic activator therapy post operatively and were followed closely. Children with long-standing condylar ankylosis of the mandible and its resultant facial asymmetry and occlusal canting [Secondry to a non functional jaint and Maxillary compensation] treated with condylectomy and interpositional flap treated more favorably when activators were used postsurgically. The patients that failed to comply with or continue activator therapy postsurgically developed complications relating to mandibular deviation, occlusal dysharmony, asymmetry and rankylosis of the temporo mandibular joint [TMJ]

Considering the second primary molar as the sole clinical index of growth condition

Assessment of skeletal maturity is an integral part of interceptive diagnosis and treatment planning. The present method of skeletal maturity assessment like handwrist or cervical vertebrae radiographies are expensive,require elaborate equipment and account for high radiation exposure, especially for growing children. This study tried to consider the value of the 2nd primary molar in growth stage. 40 samples aged 8-13 were tested by their panoramic and handwrist radiographs. there was a coincidence between presence calcified sesamoid and 2nd primary molar as the last tooth. The result showed that it could be a reliable index to predict the growth stage in 1st visit without radiography

Prediction of mandibular third molar impaction

Mandibular third molar impaction is a major problem in modern dentistry. The incomplete eruption of third molars remains a serious problem in dentistry, primarily because of its high incidence and clinical consequences.The purpose of this study was to relate the impaction of third molars to individual patterns of facial growth, as well as to the gonial angle. A group of 100 subjects with impacted mandibular third molar and a group of 75 subjects whose lower third molars had erupted. Both formed part of a cross-sectional study on prediction of impaction. There was at least 2 degrees difference between two groups. The mean value for gonial angle in erupted cases was 126 +/- 6 which is not so different from the standard ranges in the literature. Gonial angle can be used as one of impaction indices. Less value of gonial angle is in association with impacted third molar compared with erupted teeth