Temporomandibular joint reconstruction using costochondral graft.

Reconstruction of the temporomandibular joint (TMJ) after release of ankylosis by condylectomy is a challenging problem in maxillo-facial surgery. A successful reconstruction implies correct restoration of form and, in children, future symmetrical growth. Bilateral bony ankylosis of the temporomandibular joint in a female patient was diagnosed in the Oral and Maxillofacial Surgery Department of Bangabandhu Sheik Mujib Medical University (BSMMU) at the time when she had severe facial deformity with typical bird face appearance. The condition was treated with costochondral graft following a bilateral condylectomy. At the time of treatment, there was an expectation that further orthognathic surgery or bone grafting would be required to correct the skeletal deformity. However, with the release of the ankylosis and growth of the costochondral graft, a good functional and esthetic result can be achieved without further surgery. It is important that dentists be aware of the clinical signs and symptoms of TMJ ankylosis, to allow early diagnosis and treatment.

An analytic study of surgical management of the temporomandibular joint ankylosis: an experience in Bangladesh.

The clinical observations on 14 cases of temporomandibular joint (TMJ) ankylosis including age and sex incidences as well as surgical management are presented in this paper. Ankylotic TMJ arthroplasty which include condylectomy with or without interpositional materials such as auricular cartilage and temporalis muscle flap to prevent reankylosis was used as the corrective measure. The accessory procedures like costochondral grafts and saggital split osteotomy to restore ramus height accompanied by camouflaging genioplasty in some of these cases were carried out. Besides, bilateral concomitant coronoidectomy were done in all cases. The patients were divided in three groups. In four cases only condylectomy was performed; the result was poor in three cases and moderate in one case. Condylectomy accompanied by interpositioning of auricular cartilage was done in another four patients; the result was poor in one case, moderate in one case and good in 2 cases. Six subjects were treated with condylectomy along with interpositioning of temporalis muscle flap; the result was good in 5 and moderate in 1 case. Condylectomy with temporalis muscle flap appeared to be the best method for TMJ ankylosis.

Incidence of dry socket in surgical removal of impacted third molar.

In a search for dry socket five hundred and thirty six (536) impacted third molars were surgically removed among 435 patients. Each patient was examined clinically and radiographically before surgery. 108 impacted teeth were removed for prophylactic and 428 for therapeutic reasons. A standard operating procedure was performed for each case and pre-operative and post-operative regimens was employed. After surgery each case was followed to determine the absence or presence of signs and symptoms of dry socket. It was found that total incidence of alveolar osteitis (dry socket) was 10.26%.

Ameloblastoma--a clinical study of 13 cases.

Ameloblastoma is commonly encountered odontogenic tumour in Bangladesh. A clinical assessment of this tumour is presented in this paper with the particular attention to its age, and sex incidence, clinical presentation, and its management. Complete removal of the neoplasm is the treatment of choice regardless the method of accomplishment to obtain complete cure. Small lesion, particularly in young patients may by given chance to be managed by enucleation and curettage exposing the healthy surrounding tissue. However radical resection of the tumour is the most efficient treatment particularly in large tumours to avoid recurrence.