Editörden, Nihat KILIÇ, Yrd.doç.dr. Murat ÇAĞLAROĞLU, Prof. Dr. Abdulvahit ERDEM

TME Ankilozunun Masseter ve Temporal Kasların Elektromyografik Aktiviteleri ile Yüz ve Alt Çene Büyümesine Etkileri: Bir Vaka Raporu

Amaç: Bu çalışmanın amacı, çocukluk döneminde gelişen bilateral komple TME ankilozlu bir erişkin bayan hastanın elektromyografik, klinik ve radyolojik özelliklerinin rapor edilmesidir. Gereç ve Yöntem: 42 yaşındaki bayan bir hasta çift taraflı TME ankilozu tanısı koyulmuştur. Anamnestik verilere göre, hasta 5 yaşında iken bir travma geçirmiş ve bu travmada TME zarar görmüştür. Bulgular: Klinik ve radyolojik incelemeler hastada hipoplazik mandibula ve konveks profil, yüz asimetrisi, ağzı açamama, düşük ağız hijyeni, ön ve sağ posterior dişlerin tümünün yokluğu ve TME bölgesin bir kalın kemik kitle ve buna bağlı bilateralde komple ankilozun varlığını göstermiştir. Bu bulgulara ek olarak, hastanın çiğneme kaslarındaki electromyografik aktivitenin ankilozdan etkilenmiştir. Sonuç: Bu vaka raporunun sonuçları bilateral TME ankilozunun alt çene ve yüz büyümesi ile çiğneme kaslarının motor güçlerini etkilediğini göstermektedir.

Anahtar Kelimeler:

Travma, TME ankilozu, Elektromyografi, Yüz büyümesi

Activity of Masseter and Temporal Muscles and Facial and Mandibular Growth: A Case Report

Purpose:The purpose of this study is to report electromyographic, clinical and radiological featur es of an adult female patient having bilateral complete TMJ ankylosis that occurred her childhood. Material and Methods: A 42-year old female patient was diagnosed with bilateral complete TMJ ankylosis. According to anamnestic data, TMJ was injured by a trauma when she was 5 years old. Results: Clinical and radiological examinations showed that the patient had hypoplasic mandible and convex profile, facial asymmetry, 0 mm of mouth opening, poor oral hygiene, complete absence of all anterior and right posterior teeth, and a huge bone block in both TMJ area and ankylosis of both TMJs. In addition to these finding, electromyographic activities of masticatory muscles affected from TMJ ankylosis. Conclusion: The findings of the present case report showed that bilateral TMJ ankylosis has potential negative effects on facial and mandibular growth and motor outputs (EMG values) of masticatory muscles.

Keywords:

Trauma, TMJ ankylosis, Electromyography, Facial growth,

PDF

___

Kaban LB, Perrott DH, Fisher K. A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 1990;48:1145-51. Manganello-Souza LC, Mariani PB. Temporomandibular joint ankylosis: Report of 14 cases. Int J Oral Maxillofac Surg 2003;32:24-9.
Chidzonga MM. Temporomandibular joint ankylosis: review of thirty-two cases. Br J Oral Maxillofac Surg 1999;37:123-6.
Dimitroulis G. The interpositional dermis-fat graft in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 2004; 33:755
Guven O. A clinical study on temporomandibular joint ankylosis. Auris Nasus Larynx 2000;27:27-33.
Oztan HY, Ulusal BG, Aytemiz C. The role of trauma on temporomandibular joint ankylosis and mandibular growth retardation: an experimental study. J Craniofac Surg 2004; 15:274-82.
Su-Gwan K. Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg 2001;30:189-93.
Roychoudhury A, Parkash H, Trikha A. Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87:166-9.
Lupori JP, Kewitt GF, Van Sickels JE. Bilateral sagittal split osteotomy advancement and setback. In: Fonseca RJ, editor. Oral and maxillofacial surgery, Volume 2: Orthognathic surgery. Philadelphia, London, New York, St. Louis, Sydney, Toronto: W.B. Sounders Company; 2000; 297-310.
Miller GA, Page HL Jr, Griffith CR. Temporomandibular joint ankylosis: review of the literature and report of two cases of bilateral involvement. J Oral Surg 1975;33:792-803.
Yaman Z, Yenidünya MO. Maksillo-fasiyal Cerrahi. In: Yenidünya MO, editor. Plastik ve rekonstriktif cerrahiye giriş. İstanbul: Bilimsel Tıp Yayınevi, 1999; 64-92.
Cooper BC, Cooper DL, Lucente FE. Electromyography of masticatory muscles in craniomandibular disorders. Laryngoscope1991; 101:150-7.
Okeson JP. Management of Temporomandibular Disorders and Occlusion. 5. ed. St. Louis: Mosby Inc., 2003: 491-505.
McFadden LR, Rishiraj B. Treatment of temporomandibular joint ankylosis: a case report. J Can Dent Assoc 2001;67:659-63. el-Sheikh MM, Medra AM, Warda MH. Bird face deformity secondary to bilateral temporomandibular joint ankylosis. J Craniomaxillofac Surg. 1996; 24:96-103.
Sawhney CP. Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylicspacer interposition. Plas Reconst Surg 1986; 77:29–38.
Winnberg A, Pancherz H. Head posture and masticatory muscle function. An EMG investigation. Eur J Orthod 1983; 5:209-17.
Kilic N. Yarı Hızlı (Semi Rapid) Ve Hızlı Üst Çene Genişletmesinin Dentofasiyal Yapılar Ve Çiğneme Kaslarının Tonositelerinde Yaptığı Değişimlerin İncelenmesi (Thesis). Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü Ortodonti Anabilim Dalı Erzurum, 200 Miralles R, Hevia R, Contreras L, Carvajal R, Bull R, Manns A. Patterns of electromyographic activity in subjects with different skeletal facial types. Angle Orthod 1991; 61:277-84.
Fricton JR, Kroening RJ, Hathaway KM. Muscular disorders: the most common diagnosis. In: Fricton JR, Kroening RJ, Hathway KM, editors. TMJ and Craniofacial Pain: Diagnosis and Management. St Louis: MO EuroAmerica, Inc.; 1988; 67.
Yamaguchi T, Satoh K, Komatsu K, Kojima K, Inoue N, Minowa K, Totsuka Y. Electromyographic activity of the jaw-closing muscles during jaw opening-comparison of cases of masseter muscle contracture and TMJ closed lock. J Oral Rehabil 2002;29:1063-8. el-Labban NG, Harris M, Hopper C, Barber P. Degenerative changes in masseter and temporalis muscles in limited mouth opening and TMJ ankylosis. J Oral Pathol Med 1990;19:423-5. el-Labban NG, Harris M, Hopper C, Barber P. Amianthoid fibres in muscle tissue associated with temporomandibular joint ankylosis. Ultrastruct Pathol 1986;10:571-6.
McNamara JA Jr. Neuromuscular and skeletal adaptations to altered function in the orofacial region. Am J Orthod 1973;64:578-606.
Miralles R, Santander H, Ide W, Bull R. Influence of mucosal mechanoreceptors on elevator muscle activity in healthy subjects. J Prosthet Dent 1991; 65:431-5.
Nielsen IL, McNeill C, Danzig W, Goldman S, Levy J, Miller AJ. Adaptation of craniofacial muscles in subjects with craniomandibular disorders. Am J Orthod Dentofacial Orthop 1990;97:20-34. Yazışma Adresi Dr. Nihat KILIÇ
Atatürk Üniversitesi, Diş Hekimliği Fakültesi Ortodonti Anabilim Dalı, 25240, Erzurum, TURKEY. Tlf.: 90.442.2311807 Fax: 442.2360945 - 2312270 e- mail: drnkilic@yahoo.com nkilic@atauni.edu.tr