Subjective:
The patient is a 9 y.o. female that was injured from a fall when she was 4 years old. Two weeks after her fall, the patient was treated with a closed reduction and intermaxillary fixation, for a left mandibular condyle fracture. The patient was reported to be in intermaxillary fixation for 4 weeks. After removal of fixation the patient's interincisal opening remained at 10 mm.
Objective:
The patient had no known drug allergies, history of hospitalizations or operations. Oral examination revealed mixed dentition. Radiographic examination was positive for left mandibular condylar hyperplasia and lack of interarticular space. Brisement force test was positive for TMJ ankylosis with opening of 10 mm.
Assessment:
- Left TMJ Ankylosis
- Vertical Maxillary Excess
- Mandibular Retrognathia
Plan / Treatment:
- Left TMJ Interpositional Arthroplasty with insertion of .040 silastic sheeting
- Left Coronoidectomy
- Right Coronoidectomy
- Future Orthodontic Treatment
- Future Extraction of Teeth # 1, 16, 17, and 32
- Future Orthognathic Surgery
Intraoperatively, following the left TMJ arthroplasty the patient could be opened to 25 mm. The patient was redraped for the intraoral procedures. Following the left coronoidectomy the opening increased to 30 mm. The right coronoidectomy resulted in a gain of an additional 5 mm to 35 mm.
Interincisal Opening of 35 mm |
Patient treated by:
- Dr. Steven R. Tucker Oral and Maxillofacial Surgery
- Dr. Allan Reid Oral and Maxillofacial Surgery
Steven R. Tucker DMD, PSC
Oral and Maxillofacial Surgery
909 Scherm Road
Owensboro, KY 42301
phone: 1-270-926-4107
fax: 1-270-926-4166
url: www.srt-psc.com
Last Modified: June 30, 2000
