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Reconstruction of Ankylotic and Resected Mandibular Condyle by Transport Distraction Osteogenesis

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Reconstruction of Ankylotic and Resected Mandibular Condyle by Transport Distraction Osteogenesis by Xiaojian Shi
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This dissertation, "Reconstruction of Ankylotic and Resected Mandibular Condyle by Transport Distraction Osteogenesis" by Xiaojian, Shi, 施曉健, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Abstract of thesis entitled Reconstruction of Ankylotic and Resected Mandibular Condyle by Transport Distraction Osteogenesis Submitted by Shi Xiao-jian For the degree of Doctor of Philosophy at the University of Hong Kong in 2008 Ankylosis of the tempromandibular joint (TMJ) is a severe disability that results in restricted mouth opening and masticatory difficulty. Treatment of TMJ ankylosis is one of the greatest challenges in oral and maxillofacial surgery. Severe functional and cosmetic impairment may result when the jaws are not reconstructed. A variety of techniques for treatment of ankylosis have been described in literature. The use of autogenous costochondral graft in reconstruction of TMJ is considered to be the gold standard. However, this reconstructive technique has many shortcomings. Distraction osteogenesis is a technique to create new bone without the need of bone grafting therefore the donor site morbidity is obviated. This technique is gaining increasing popularity in the oral and maxillofacial region, particularly for the management of craniofacial deformities. So far, there is no experimental study reported in the literature related to reconstruction of ankylotic mandibular condyle by distraction osteogenesis. The main reason was the difficulty to create a TMJ ankylosis in an I animal model. The purposes of the this PhD study were to (1) develop an animal model of TMJ bony ankylosis for future evaluation of surgical reconstructive methods; (2) compare the distraction osteogenesis versus costochondral graft in TMJ reconstruction; (3) compare the distraction osteogenesis versus costochondral graft in reconstruction of TMJ after condylectomy with disc preservation. In the first experiment, 4 mini-pigs and 4 goats were selected to create a unilateral TMJ ankylosis model. Goats were found to be more suitable than mini-pigs regarding the formulation of fibro-osseous ankylosis. A subsequent experiment of bilateral induction of TMJ ankylosis in goats was able to obtain reliable bony ankylosis in the TMJ. In the second experiment, 12 goats were used to compare distraction osteogenesis versus costochondral graft in TMJ reconstruction after surgical removal of ankylotic TMJs. Firstly; TMJ ankylosis was induced bilaterally in all 12 goats. After surgical excision of the ankylosed condyles bilaterally, TMJ reconstruction using costochondral graft was performed on one side whereas distraction osteogenesis on the other. Postoperative radiographic examination and histological examination demonstrated that both methods were useful in reconstructing a mandibular condyle following surgical removal of the original ankylosed TMJ. In the third experiment, distraction osteogenesis was compared with costochondral II graft in TMJ reconstruction after condylectomy with disc preservation. Condylectomy with disc preservation of both TMJs was performed in a second series of 12 goats. Costochondral graft on the right side and distraction osteogenesis on the left side were used to reconstruct the condyle. Postoperative radiographic examination and histological examination demonstrated that distraction osteogenesis of the ramus healed reliably with regeneration of a cartilaginous cap after condylectomy with disc preservation. The neo-condyle obtained by distraction osteogenesis matched the gold standard of condylar re
Release date NZ
January 27th, 2017
Author
Contributor
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Country of Publication
United States
Illustrations
colour illustrations
Imprint
Open Dissertation Press
Dimensions
216x279x10
ISBN-13
9781361438008
Product ID
26643488

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