Evaluation of the Sternoclavicular Graft for the Reconstruction of Temporomandibular Joint After Gap Arthroplasty.

INTRODUCTION: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. A number of interpositional materials have been used including alloplastic materials (acrylic, proplast-teflon, silastic), and autogenous tissues (temporalis muscle flaps, buccal fat pad, dermis, costochondral grafts, metatarsal, fibula, tibia, iliac crest, cranial bone and Sternoclavicular graft SCG and cartilage). Literature suggests that rather than growth centre, we need adaptive centre. SCG is presumed to be a more suitable material for interpositional arthroplasty because Sternoclavicular Joint (SCJ) and TMJ are very similar developmentally, histologically and morphologically throughout the growth period. MATERIAL AND METHOD: Patients with TMJ ankylosis (8 males, 2 females) underwent release of the ankylosed joint by the senior author, between June 2013 and Novemeber 2015. The age of the patients ranged from 10 to 19 years. Pre- and post- operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate. RESULT: MIO at 6 months follow up was 37.4±2.633 mm (range 32-40 mm), greater than MIO achieved in immediate postoperatively {34.4±2.22 mm (range 30-38 mm). After reconstruction of temporomandibular joint with sternoclavicular graft in the growing child there was a significant increase in the growth of mandible which was stunned due to ankylosis. And the ramal height also increased. CONCLUSION: The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.

Esthetic correction of depressed frontal bone fracture.

Depressed frontal bone fractures are occasionally seen in maxillofacial trauma patient. If untreated, they look un-esthetic. Although there are numerous options available for correction of these defects, use of bone cement (polymethylmethacrylate or PMMA) is simple and reliable. This is the report of one such case.

Comparison of direct immunofluorescence and ELISA for the detection of Chlamydia trachomatis antigen in the patients of pelvic inflammatory disease.

Fifty female patients clinically diagnosed as pelvic inflammatory disease (PID) attending Gynaecology OPD of Smt. Sucheta Kriplani Hospital were studied for the presence of Chlamydial antigen by direct immunofluorescence (DFA) and Enzyme linked immunosorbant assay (ELISA) test. Out of fifty PID patients Chlamydia tracchomatis lipopolysaccharide antigen could be detected in 28% of cases by ELISA and Chlamydial outer membrane protein antigen could be detected in 32% of cases by DFA. Although in the present study DFA and ELISA compare well with each other, but DFA has been found to be more specific test as it detects outer membrane protein antigen of Chlamydia trachomatis.