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Ankylosis of the temporomandibular joint (TMJ) is a condition in which the mandibular condyle fuses with the mandibular fossa through fibrous or bone tissue. It is a debilitating pathology that interferes with chewing, speaking, and oral hygiene. Currently, alloplastic reconstruction is considered the gold standard for treating severely compromised TMJs, such as in ankylosis. The article describes a patient with a history of facial trauma, with bilateral ankylosis of the TMJs, inability to open his mouth, and poor dental condition. Due to a long period of immobilization of approximately 40 years, the initial treatment plan was to remove the ankylosis bilaterally and install customized PMMA (polymethylmethacrylate) spacers. The patient gained mouth opening and improved chewing quality with one year of customized spacer use prior to definitive alloplastic replacement with stock-type TMJ prostheses. Customized joint spacers are a provisional treatment option when definitive alloplastic reconstruction is not indicated. Spacers provide the patient with progressive jaw function and mobility gains.

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A anquilose da articulação temporomandibular (ATM) é caracterizada pela união intracapsular do complexo disco-côndilo à superfície do osso temporal, podendo gerar restrição dos movimentos mandibulares e limitação de abertura bucal. São descritas ainda alterações como restrição da capacidade mastigatória, dificuldade de fonação e de uma adequada higiene bucal, além de dificuldade de interação social. O presente caso retrata um paciente feminino, 27 anos, com histórico de fratura de parassínfise e côndilo mandibular bilateral após trauma em 2014, evoluindo com anquilose da ATM direita, com abertura máxima de 13,27 mm. Para o tratamento do caso descrito, foi utilizado o acesso de Al-Kayat, coronoidectomia ipsilateral e ressecção de massa anquilótica em gap com interposição de retalho da fáscia do músculo temporal no lado direito. Após seis meses do procedimento cirúrgico, foi realizada uma nova tomografia da face na qual se observa ausência de lesões e de sinais de recidiva da anquilose e também foi observada a manutenção do espaço de lacuna feita pela ressecção óssea. O resultado satisfatório da técnica foi atribuído pela obtenção e estabilização de uma abertura bucal adequada, melhora da capacidade mastigatória e da fonação. Além do sucesso clínico, uma vantagem da técnica utilizada foi o baixo custo do procedimento por utilizar apenas interposição do músculo temporal sem uso de materiais aloplásticos. Além disso, a coronoidectomia ipsilateral associada foi suficiente para auxiliar na manutenção da abertura alcançada, não sendo necessária a coronoidectomia contralateral, o que minimizou o tempo operatório e a morbidade de mais um sítio cirúrgico acessado.

Ankylosis of the temporomandibular joint (TMJ) is characterized by the intracapsular union of the condyle- disc complex to the surface of the temporal bone, which can cause restriction of the mandibular movements and a limitation of a mouth opening. Alterations are also described as a restriction of masticatory capacity, difficulty in phonation and suitable oral hygiene, as well as difficulty in social interaction. A 27-year-old female patient with a bilateral history of parasymphysis and mandibular condyle fracture after a trauma in 2014, which evolved to an ankylosis of the right TMJ, with a maximum mouth opening of 13.27 mm. For the treatment of the described case, it was used the Al- Kayat approach, ipsilateral coronoidectomy and resection of the ankylotic mass in gap with interposition of temporalis muscle fascia flap on the right side. After six months of the surgical procedure, it was made a new computed tomography of the face in which it was possible to notice the absence of lesions and signs of recurrence of the ankylosis. It was also observed the maintenance of the gap space made by the bone resection. The satisfactory result of the technique was attributed to the achievement and stabilization of an adequate mouth opening, improved chewing ability and phonation. Besides the clinical success, an advantage of the technique used was the low cost of the procedure by using only temporal muscle interposition without the use of alloplastic materials. In addition, the associated ipsilateral coronoidectomy was sufficient to help maintaining the achieved mouth opening, and the contralateral coronoidectomy was not necessary, as a result it was minimized the surgical time and morbidity of one more accessed surgical site.

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Pterosaurs are an extinct group of Mesozoic flying reptiles, which exhibited high diversity with regard to their dentition. Although morphological features of pterosaur dentition have been described in detail in several contributions, the histology of tooth and tooth attachment tissues (i.e. periodontium) has been scarcely analysed to date for this clade. Here we describe and interpret the microstructure of the tooth and periodontium attachment tissues of Pterodaustro guinazui, a filter-feeding pterodactyloid pterosaur from the Lower Cretaceous of Argentina. The histological analysis of the lower jaw and its filamentous teeth verifies that the geometry of the implantation corresponds to an aulacodont condition (i.e. teeth are set in a groove with no interdental separation). This pattern departs from that recorded in other archosaurs, being possibly also present in other, non-closely related, pterosaurs. Regarding tooth attachment, in contrast to other pterosaurs, there is no direct evidence for gomphosis in Pterodaustro (i.e. the absence of cementum, mineralized periodontal ligamentum and alveolar bone). Nevertheless, the current evidence for ankylosis is still not conclusive. Contrary to that reported for other archosaurs, replacement teeth are absent in Pterodaustro, which is interpreted as evidence for monophyodonty or diphyodonty in this taxon. Most of the microstructural features are possibly related to the complex filter-feeding apparatus of Pterodaustro and does not appear to represent the general pattern of pterosaurs.

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This case report describes the successful 10-years interdisciplinary treatment of ankylosed upper central incisors with an anterior vertical ridge defect. This treatment was challenging as ankylosis was present before the growth spurt. Orthodontic treatment in association with decoronation, a xenogeneic bone graft, an autogenous sub-epithelial connective tissue graft, and implant placement were performed to correct the vertical ridge defect and to re-establish appropriate function, gingival health, and aesthetics. Decoronation performed during the growth spurt was the key to avoiding alveolar ridge deformity.

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INTRODUCTION: The treatment of impacted and transposed teeth is a challenge for clinical practice. A precise assessment of the relative position of the transposed tooth could lessen the risks of adverse effects, such as root resorption and periodontal problems. DESCRIPTION OF THE CASE: An 18-year-old patient went to the Orthodontic Department of the Federal University of Juiz de Fora, Brazil for a re-evaluation of the orthodontic treatment to which she had been receiving since the age of 12. Attempted traction of an impacted maxillary canine resulted in root resorption, marked mobility and alteration in the position of adjacent teeth as well as loss of alveolar bone in the anterior region of the maxilla. This tooth was not only partially transposed, but it also had ankylosis, external and internal tooth resorption, which indicated the need for tooth extraction. A change was made to the treatment plan, with the extraction of the canine, bone graft and mesial movement of the posterior teeth. RESULTS: All the spaces were closed at the end of treatment, with normal overbite and overjet. At the follow-up, the teeth position, the shape of dental arches, disocclusion guides and dental occlusion were preserved. The bone graft in the maxilla showed height and mineral density stability. CONCLUSION: The presence of the maxillary permanent canines in the dental arch is important for both aesthetics and a functional occlusion. However, despite the importance of their maintenance in the arch, it is well advised that each case be analysed individually.

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ABSTRACT Introduction: The decoronation technique has been described in literature since 1984 and, based on the available results, it can lead to considerable benefits for the repair and rehabilitation of ankylosed teeth. Based on these reports, one could expect that this procedure would be well known by the dental community. However, this fact does not seem to be true, and this procedure is not widely used. Methods: The objective of this paper is to present appropriate literature that discusses decoronation and evaluate the perspectives of the procedure, both in relation to the technique and the long-term benefits for the patient. An integrative literature review at PubMed, ScieELO, and Lilacs databases was performed using the keywords "decoronation", "ridge preservation decoronation", "decoronation ankylosis". In addition, a case report will be presented to demonstrate the technique in a systematic and detailed manner. Results: Considering the inclusion criteria, 27 articles that present consistency regarding decoronation were selected. Conclusion: There is scarce availability of scientific works related to the topic, to corroborate and discuss the technique. The present paper reinforces the benefits of this procedure, and revisit decoronation, attempting to provide a possible treatment for ankylosed teeth in growing patients.

RESUMO Introdução: A técnica de decoronação é descrita na literatura desde 1984 e, com base nos resultados disponíveis, pode trazer benefícios consideráveis para o reparo e reabilitação de dentes anquilosados. Com base nesses relatos, seria esperado que esse procedimento fosse bem conhecido pela comunidade odontológica. No entanto, isto não parece ser verdadeiro e esse procedimento não é amplamente utilizado. Objetivo: O objetivo deste artigo é apresentar literatura adequada que discuta a decoronação e avalie as perspectivas do procedimento, tanto em relação à técnica quanto aos benefícios em longo prazo para o paciente. Métodos: Foi realizada revisão integrativa da literatura nas bases de dados PubMed, SciELO e Lilacs, utilizando as seguintes palavras-chave: "decoronation", "ridge preservation decoronation", "decoronation ankylosis". Além disso, um relato de caso demonstrará a técnica de maneira sistemática e detalhada. Resultados: Considerando os critérios de inclusão, foram selecionados 27 artigos que apresentam consistência quanto à decoronação. Conclusão: Há escassa disponibilidade de trabalhos científicos relacionados ao tema para corroborar e discutir a técnica. Esse artigo reforça os benefícios desse procedimento e revisa a decoronação na tentativa de fornecer um possível tratamento para dentes anquilosados em pacientes em crescimento.

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BACKGROUND: There are several indications for partial or total replacement of the temporomandibular joint (TMJ), including neoplasms and severe bone resorptions. In this regard, several techniques have been suggested to increase the functionality and longevity of these prosthetic devices. This case report describes the treatment of a TMJ ankylosis patient with the Puricelli biconvex arthroplasty (ABiP) technique, with a long-term follow-up. CASE PRESENTATION: In 1978, a 33-year-old male polytraumatised patient developed painful symptoms in the right preauricular region, associated with restricted movement of the ipsilateral TMJ. Due to subcondylar fracture, an elastic maxillomandibular immobilisation (EMMI) was applied. Subsequently, the patient was referred for treatment when limitations of the interincisal opening (10 mm) and the presence of spontaneous pain that increased on palpation were confirmed. Imaging exams confirmed the fracture, with anteromedial displacement and bony ankylosis of the joint. Exeresis of the compromised tissues and their replacement through ABiP was indicated. The method uses conservative access (i.e., preauricular incision), partial resection of the ankylosed mass, and tissue replacement using two poly(methyl methacrylate) components, with minimal and stable contact between the convex surfaces. At the end of the procedure, joint stability and dental occlusion were tested. The patient showed significant improvement at the postoperative 6-month follow-up, with no pain and increased mouth opening range (30 mm). At the 43-year follow-up, no joint noises, pain or movement restrictions were reported (mouth opening of 36 mm). Imaging exams did not indicate tissue degeneration and showed the integrity of prosthetic components. CONCLUSIONS: The present case report indicates that ABiP enables joint movements of the TMJ, allowing the remission of signs and symptoms over more than 40 years of follow-up. These data suggest that this technique is a simple and effective alternative when there is an indication for TMJ reconstruction in adult patients with ankylosis.

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ABSTRACT Objective: This article aims to discuss the multidisciplinary approach required in the treatment of cases of impaction and ankylosis of permanent teeth, associated with a history of trauma, considering the psychological state of the child and family when faced with a traumatic case of bullying, by reporting the complex treatment of a central incisor needing to be orthodontically moved across the midline. Conclusion: This clinical case was a major challenge, which included complex multidisciplinary procedures. Results and stability after 26 months of retention indicated successful orthodontic space closure of two maxillary teeth, without the use of implants or prostheses, in an adolescent patient who had a history of dental trauma, alveolar bone loss, and an uncertain initial prognosis.

RESUMO Objetivo: O presente artigo tem como objetivo discutir a abordagem multidisciplinar necessária no tratamento de casos de impacção e anquilose de dentes permanentes, associados a histórico de trauma, considerando o estado psicológico da criança e da família diante de situações traumáticas de bullying, por meio do relato do tratamento complexo de um incisivo central que precisava ser movido ortodonticamente através da linha média. Conclusão: Esse caso foi um grande desafio, que incluiu procedimentos multidisciplinares complexos. Os resultados e a estabilidade após 26 meses de contenção indicaram fechamento ortodôntico bem-sucedido do espaço de dois dentes superiores, sem o uso de implantes ou próteses, em uma paciente adolescente que apresentava histórico de trauma dentário, perda de osso alveolar e prognóstico inicial incerto.

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La anquilosis de la articulación temporomandibular en niños continúa siendo una patología presente a pesar de los avances médicos y sociales. El tratamiento de esta patología en niños tiene como objetivos restablecer la apertura bucal y mejorar la estética facial cuando se presentan hipoplasias o micrognatias asociadas. El uso de materiales aloplásticos para el tratamiento de la anquilosis temporomandibular en niños es evitar la reanquilosis y disminuir riesgos, molestias y costos que ocasionan la toma y aplicación de injertos, siendo utilizados con buenos resultados en niños en otras especialidades como la Traumatología y Ortopedia. Estos procedimientos pueden llevarse a cabo de manera segura y predecible. En este artículo se reportan dos casos de anquilosis temporomandibular en niños, tratados con materiales aloplásticos, llevados a cabo en la Unidad Médica de Alta Especialidad No. 71 del Instituto Mexicano del Seguro Social, Torreón, Coahuila, México, con un seguimiento de 11 y 16 años de postoperatorio, demostrando que se trata de una buena opción de tratamiento sin presentar alteraciones al crecimiento y desarrollo de los pacientes (AU)

Temporomandibular ankilosis in children is pathology still present despite the medical and social advances. The treatment of this pathology in children aims to restore mouth opening and improve facial aesthetics when hypoplasia or micrognatia are present. The use of alloplastic materials to treat temporomandibular ankilosis in children is to prevent the re ankilosis and reduce discomfort, risks, and cost causing by the take and application of graft, alloplastic materials being used with good results in children in other specialties such as Traumatology and Orthopedics. These procedures can be made safely and predictably. This article describes two cases of temporomandibular ankilosis in children, treated with alloplastic materials, carried out in the Medical Unit of High Specialty, number 71, of the Mexican Institute Social Security, Torreon, Coahuila, Mexico, with follow up of cases 11 and 16 years of postoperative, prove that is a good option of treatment, without presenting any alterations in growth and development of patients (AU)

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The oromandibular limb hypogenesis syndromes (OLHS) represent a group of rare conditions characterized by congenital malformations involving the tongue, mandible, and limbs. In this report, we describe a newborn girl with paralysis of abducens and facial nerves, transverse agenesis of the distal segments of the limbs, micrognathia, cleft lip and palate, and ankyloglossia superior. This observation confirms an overlap between Moebius syndrome and ankyloglossia superior syndrome with severe limb defects. The etiology of the OLHS is not clearly understood. The intriguing link between facial and limb anomalies can result from their simultaneous development from the fourth to eighth week of gestation, making both areas susceptible to the same teratogenic stimuli. There is an overlap between OLHS conditions, supporting a clustering, rather than a divided nosology and requiring an appropriate classification of these conditions. Patients with OLHS can be successfully managed using a multidisciplinary approach.

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OBJECTIVES: To evaluate denosumab, a human monoclonal antibody that mimics the effects of osteoprotegerin in bone metabolism, as a topical treatment of root surface to be used prior to delayed tooth replantation. MATERIALS AND METHODS: Thirty-six rats' right incisors were used. Teeth were extracted and divided into: delayed replantation without root surface treatment (control); delayed replantation with root surface treatment with denosumab 60 mg/mL and 30 mg/mL, respectively, for 10 min both experimentals groups. After that, the root canals were filled with calcium hydroxide and replanted. After 15 and 60 days, the animals were euthanized, and the samples were collected and processed for microscopic analysis. Histological sections were performed, and stained with HE to describe the dental characteristics, measure ankylosis, replacement resorption, and dental resorption by conventional microscopy. Also, was performed Brown & Brenn staining and immunohistochemistry for RANKL, OPG, and periostin. RESULTS: Denosumab 60 mg/mL reducted ankylosis (p < 0.0001), replacement resorption (p < 0.0001), and tooth resorption, 60 days after replantation, compared to untreated replanted teeth (p < 0.005). Lower bacterial contamination in root surface in the denosumab treatment groups was found, regardless of the concentration used (p < 0.001). Also, denosumab treatment inhibited the expression of RANKL without modulating OPG. Periostin was observed in periodontal ligament of replanted tooth, although this labelling was absent in the ankylosis areas, in both experimental periods. CONCLUSION: Treatment of the root surface with denosumab at 60 mg/mL of rat teeth before delayed replantation reduced dental root resorption compared with the untreated teeth after 60 days. CLINICAL RELEVANCE: Survival of a replanted tooth has been a challenge in clinical practice. The use of a medication, such as denosumab, to limit dental root resorption represents an important therapeutical approach.

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Introducción: la anquilosis temporomandibular se caracteriza por la limitación en la apertura bucal, lo que conlleva alteraciones estéticas, de la masticación, el lenguaje y respiratorias. El objetivo del reporte es describir las características clínicas de los pacientes y evaluar resultados del tratamiento quirúrgico para la anquilosis temporomandibular. Materiales y métodos: presentamos un estudio observacional, descriptivo y retrospectivo en el que se revisaron las historias clínicas e imágenes de todos los pacientes operados de anquilosis de la articulación temporomandibular desde enero 2008 a diciembre de 2016. Resultados: se intervinieron 44 casos, cuya etiología principal eran los traumatismos (70,5 %), con predominio femenino en el 77,3 % de los casos y la presentación unilateral como la más frecuente con el 70,5 % del total. La edad de mayor frecuencia de presentación fue entre 6 a 10 años con el 47,7 % de los casos. La cirugía más realizada fue la condilectomía con coronoidectomía en el 79,5 % de los casos. Como complicación más frecuente se encontró la parálisis de la rama palpebral en el 13,7 %, y obteniendo un 6 % de recidiva. Discusión: los resultados presentados son similares a otras publicaciones, ya que se reprodujo el tratamiento protocolizado mundialmente y no se encontraron diferencias significativas en cuanto a etiología, edad, tratamiento realizado y complicaciones. Conclusiones: la anquilosis temporomandibular es una patología que requiere de un tratamiento quirúrgico que logre la resección del bloque anquilótico, así como la asociación de otras técnicas quirúrgicas como la realización de un colgajo para disminuir la posibilidad de recidiva y distracción ósea para restablecer la anatomía mandibular.

Introduction: Temporomandibular ankylosis limits the mandibular function, decreasing the buccal opening, with aesthetic alterations as well as chewing language and even respiratory disfunction. Objective: To describe the patients clinical paticularities and evaluate the surgical treatment results for this pathology. Design: Observacional, descriptive and retrospective study. Methods: We reviewed the medical histories and images of all the patients who underwent temporomandibular ankylosis release from January 2008 to December 2016. Results: It involved 44 cases, being the main etiology injuries in a 70.5%, with predominance of the female sex in the 77.3% and the unilateral presentation with the 70.5% of the cases. Ages between 6 to 10 years were the most frequent ones with 47.7%. The surgery most performed was the condilectomia with coronoidectomy in 79.5% of the cases. The most frequent complication was the palpebral branch paralysis in 13.7% and we had a 6% of ankylosis recurrence. Discussion: Our results are similar to other publications when reproducing the worldwide protocolized treatment, without finding significant differences in terms of etiology, age of presentation, treatment carried out and complications. Conclusions: Temporomandibular ankylosis is a condition that requires surgical treatment, which is aimed to anatomical and functional restoration. Wide bone resection complemented with other surgical techniques such as flap interposition to minimize the relapse possibility and bone distraction to restore the mandibular anatomy.

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ABSTRACT Introduction: Teeth frequently fail to erupt and situations arise that prevent the canines from reaching the occlusal plane. Objective: Discourse about the three situations in which the canine does not reach the occlusal plane, and remains unerupted; and at the same time, point how to make a safe diagnosis of alveolodental ankylosis - one of the three causes -, based on tomography. Conclusions: Ankylosis occurs in impacted teeth by atrophy of the periodontal ligament, including the epithelial rests of Malassez. The tomographic signs of alveolodental ankylosis in unerupted canines are the interruption of hypodense periodontal space, discontinuity of the lamina dura and its continuity with the root surface, which gradually loses its regular shape.

RESUMO Introdução: Muitas vezes, a erupção falha, e ocorrem situações que impedem que os caninos cheguem até o plano oclusal. Objetivos: Discorrer sobre quais as três situações nas quais o canino não chega até o plano oclusal, permanecendo não irrompido e, ao mesmo tempo, destacar como se diagnosticar com segurança uma dessas três causas, a anquilose alveolodentária, a partir da tomografia. Conclusões: A anquilose em dentes não irrompidos ocorre pela atrofia do ligamento periodontal, incluindo os Restos Epiteliais de Malassez. Os sinais tomográficos de uma anquilose alveolodentária em caninos não irrompidos são a interrupção do espaço periodontal hipodenso, a descontinuidade da lâmina dura e a sua continuidade com a superfície radicular, que, gradativamente, perde sua regularidade.

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Introdução: Os casos de assimetria facial são um desafio para tratamento no âmbito da cirurgia Bucomaxilofacial, devido a alteração craniofaciais nos três planos do espaço (Pitch,Yaw e Roll). Estes termos são utilizados para o planejamento da cirurgia ortognática e são essenciais para o planejamento virtual, A utilização da tecnologia neste sentido vem sendo cada vez mais empregada devido a sua previsibilidade de resultado tanto nos casos convencionais como nos mais desafiadores como os das assimetrias faciais. Este artigo visa relatar o planejamento virtual para a correção de um caso de assimetria através da cirurgia ortognática. Relato de caso: Paciente pediátrico leucoderma, do sexo masculino com 5 anos, possui limitação na abertura de boca, desvio da mandíbula para o lado direito com tempo de evolução de 5 meses. O procedimento consistiu na remoção da massa fibrótica através do acesso de Al Kayat. Após o procedimento cirúrgico o paciente foi submetido a uma série de sessões de fisioterapia agressiva. Considerações finais: A associação da remoção da massa fibrótica ou do bloco anquilótico e a fisioterapia intensa no pósoperatório propiciaram um resultado satisfatório, devolvendo a função mandibular do paciente... (AU)

Introduction: The temporomandibular ankylosis consists in mandibular movements limitation and is characterized as complete fusion of mandibular condyle to articular fossa or as a formation of a fibrotic mass in the region. Case Report: Pediatric male patient, white, 5 year-old, had a mouth opening limitation, mandibular deviation to the right side with 5 mouths of evolution. The procedure consisted in the removal of the fibrotic mass through the Al-Kayat approach. After the surgical procedure the patient was submitted to a series of aggressive physiotherapy sessions. Final considerations: The association of the removal of the fibrotic mass or the ankylotic bloc to intense physiotherapy in the post operatory provides a satisfactory result, restoring patient´s mandibular function... (AU)

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The temporomandibular joint (TMJ) ankylosis describes the bone or fibrous adhesion of the TMJ components, with functional impairment. The present report shows the surgical correction the TMJ ankylosis due to a condyle fracture in a child. A 12-year-old patient, female, attended to the Oral and Maxillofacial Surgery Department of the Clinical Hospital/Federal University of Uberlândia, showing severe mouth opening limitation (9 mm) and history of bilateral condyle fracture and symphysis fracture. The right TMJ ankylosis was diagnosed, removed, reshaped, and repositioned to form the reshaped condyle, by the sliding reconstruction of the condyle using posterior border of mandibular ramus and myofascial interposition of the temporal fascia. Five months of follow-up showed mouth opening of 44 mm maintained after 2 years, without complaints. The surgical treatment of the TMJ ankylosis is needed for the reestablishment of the immediate function; however, the patient must be watched until the end of development.

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INTRODUCTION: It is our understanding that there is no consensual solution for the treatment of post-traumatic patellar ankylosis; therefore, the purpose of this work is to present two cases of patellofemoral retinacular interposition arthroplasty, and its corresponding technical note. CASE 1: Female, 24, patellar ankylosis secondary to supratranscondylar fracture, associated with comminuted diaphyseal tibia fracture. CASE 2: Female, 48, patellar ankylosis secondary to femoral diaphysis and lateral femoral condyle fracture. RESULTS: After going through a patellofemoral retinacular interposition release, both patients were satisfied with the results, presenting with significantly improved knee range of motion. CONCLUSION: Using our surgical technique, we were not able to restore normal function to our patients, but their improvement was certainly impressive relative to their initial clinical situation.

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Temporomandibular joint (TMJ) ankylosis is a disease commonly associated with facial trauma, especially in the condylar region. Described as a heterotopic bone growth that causes mouth opening limitation, it may occur in trauma cases misdiagnosed or mistreated. We present the case of a 37-year-old female, with decreased mouth opening after three traumas in the region of the right condyle by a motorcycle accident. We performed custom-made total joint replacement of the TMJ to rehabilitate the patient post arthroplasty. TMJ Concepts® protocol was followed to perform the patient's rehabilitation. She is being followed since then by a physical therapist to regain the pre-pathosis status of mouth opening, speech, and mastication function.

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Introducción: resulta de interés para médicos y especialistas el conocimiento sobre la incapacidad de la apertura de la cavidad oral debido a coaliciones entre los elementos óseos y fibrosos en la región glenoidea. Objetivo: revisar la literatura sobre las características de esta patología. Desarrollo: en el primer trimestre del año 2006, a fin de realizar una revisión bibliográfica no exhaustiva para localizar la información disponible sobre la anquilosis de la articulación temporomandibular, se realizó una búsqueda bibliográfica en Scielo, Medline, Isi Web of Knowlegde y Dialnet, buscando como palabras clave: anquilosis (ankylosis) y articulación temporomandibular (temporomandibular joint). Además de la búsqueda computarizada se realizó una búsqueda manual entre las referencias de los estudios seleccionados. Conclusiones: la anquilosis temporomandibular resulta una entidad clínica compleja, usualmente molesta para los pacientes dada la imposibilidad de alimentarse y nutrirse adecuadamente, además de las deformidades que desde el punto de vista estético afecta la esfera psicológica de las personas aquejadas. Su tratamiento es difícil, no obstante, una atención adecuada minimiza las consecuencias de las complicaciones que pueden aparecer como resultado de la técnica quirúrgica u otros factores no relacionados con ella. Se reconoce que una identificación y tratamiento oportuno del problema puede favorecer los buenos resultados de la conducta médica y la rápida integración del paciente a la sociedad(AU)

Introduction: it is of interest for physicians and specialist's knowledge about the inability of the opening of the oral cavity due to coalitions between the bone and fibrous elements in the glenoid region. Objective: to review the literature on the characteristics of this pathology. Development: in the first quarter of 2006, in order to perform a non-exhaustive literature review to locate the available information on ankylosis of the temporomandibular joint, a literature search was carried out in Scielo, Medline, Isi Web of Knowlegde and Dialnet, searching as key words: ankylosis (ankylosis) and temporomandibular joint (temporomandibular joint). In addition to the computerized search, a manual search was made among the references of the selected studies. Conclusions: the temporomandibular ankylosis is a complex clinical entity, usually annoying for patients given the impossibility of feeding and nourishing adequately, in addition to the deformities that from the aesthetic point of view affects the psychological sphere of the people afflicted. Its treatment is difficult, nevertheless, an adequate attention minimizes the consequences of the complications that can appear as a result of the surgical technique or other factors not related to it. It is recognized that an identification and timely treatment of the problem can favor the good results of medical behavior and the rapid integration of the patient into society(AU)

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Abstract Intertrochanteric fractures of the femur in ankylosed hips are extremely rare. The aims of the operative management for elderly patients with intertrochanteric fractures are to prevent general complications, to maintain mobility, and to relieve pain. The optimal management to achieve these goals is not clear. The authors present a case of a 74-year-old man with an intertrochanteric fracture of the femur in an ankylosed hip. The fracture was managed surgically with dynamic hip screws and cannulated screws. Two years after the surgery, good union was observed at the fracture, and the patient was ambulating independently.

Resumo A fratura intertrocantérica do fêmur em um quadril anquilosado é extremamente rara. O objetivo do manejo operatório em idosos com fraturas intertrocantéricas é prevenir complicações gerais, manter a mobilidade, e aliviar a dor. O manejo ideal para atingir tal objetivo não é claro. Os autores apresentam o caso de um paciente do sexo masculino de 74 anos com fratura intertrocantérica do fêmur em um quadril anquilosado. A fratura foi tratada cirurgicamente com parafuso de quadril dinâmico e parafuso canulado. Dois anos após a cirurgia, observou-se boa união na fratura, e o paciente deambula de forma independente.

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RESUMO

Background: The metacarpophalangeal and metatarsophalangeal joints are very demanded during high intensity exercises,and may be affected by osteoarthritis, fractures, luxations and rupture of the suspensory apparatus. Thus, arthrodesis maybe indicated to restore joint stability and accelerate the ankylosis process. The most commonly used surgical techniqueshave been associated with postoperative complications, including infection and failure of the implants, so it is importantto develop procedures that are less invasive procedures and promoting stable fixation. Therefore, the aim of this work isto report the use of the modified steel basket technique for metatarsophalangeal arthrodesis in a foal with hyperextensionof the joint due to rupture of the digital flexor muscles.Case: A 2-day-old male foal was admitted to clinical care, presenting multiple cutaneous wounds caused by dogs bites,located in the tarsus and thigh of the hindlimb. The animal presented in standing position and had no difficulty of movement,being initially treated through daily cleaning of the cutaneous wounds and systemic antibiotic therapy. Hyperextension ofthe metatarsophalangeal joint was evidenced after 20 days, being approached through tenotomy and tendon shortening,followed by tenorrhaphy and immobilization for 30 days. Due to the failure of the treatment, it was opted for metatarsophalangeal arthrodesis by modified steel basket technique. The procedure involved the implantation of a steel basket of25.0 mm in diameter x 25.0 mm long in a 24.0 mm hole created on the dorsal surface between the third metacarpal andthe proximal phalanx. The basket was filled with bone extracted from drilling and fixed with two cortical screws at anangle of 25° toward proximoplantar and distoplantar direction. Immobilization of the limb was performed postoperativelywith synthetic plaster cast for 45 days and, due to the persistence of lameness...(AU)

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