Temporomandibular eklem osteoartritli hastaların cerrahi öncesi ve sonrası kinematik değerlendirilmesi
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Dosyalar
Tarih
2007
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Arastırmanın amacı; dejeneratif temporomandibular eklem düzensizligi (osteoartrit) hastalarının, metal fossa-eminens parsiyel eklem protezi ile cerrahi tedavisi öncesi ve sonrasında, kinematik ve klinik bulgularını degerlendirmektir. Sunulan çalısmada dejeneratif temporomandibular eklem hastalıgı olan 16 bayan ve 1 erkek hasta (18 eklem) metal parsiyel fossa-eminens eklem protezi ile tedavi edilmistir. Çalısmayı tamamlayan hastaların subjektıf bulguları görsel analog hasta anketleri ile degerlendirilmistir. Hastaların objektif bulguları ise bu çalısma için özel olarak gelistirilmis, elektromanyetik hareket kayıt sistemi kayıtları ve bilgisayarlı tomografi görüntülerinin, dental plaklar aracılıgı ile birlestiren, bir sistem kullanılarak toplanmıstır. Hastaların ameliyat öncesi ve sonrası maksimum agız açma sırasındaki mandibular kesici ve kondil kinematikleri kayıt edilmistir. Tedavi edilen kondil kontrol grubunu olustururken, tedavi edilmeyen kondil kontrol grubunu olusturmustur. Objektif ve subjektıf verilerin tedavi öncesi ve sonrası degisimlerin degerlendirilmesi eslestirilmis t testi ile SAS 8.2 yazılımı kullanılarak yapılmıstır. Cerrahi tedavi sonrası hastaların agrılarının azaldıgı ve fonksiyonel hareketlerin kolaylastıgı izlenmistir. Alt kesici hareket miktarı ameliyat sonrasında statiksel olarak anlamlı bir artıs göstermistir. Ayrıca hastaların ameliyat sonrasında ameliyatlı tarafa deviasyon gösterdikleri izlenmistir. Kontrol grubundaki kondil hareketleri ameliyat sonrasında istatistiksel olarak anlamlı bir degisim göstermezken, çalısma grubundaki kondil hareketleri azalmıstır. Kontrol ve çalısma grubu arasındaki kıyaslamada bu azalmanın kondilin inferior yöndeki hareketinin azalmasından kaynakladıgı izlenmistir. Sonuç olarak fossa ve eminensin yapısının degistirilmesinin kondil hareket miktarı ve yönünü degistirdigi gözlenmistir. Bu arastırmada kullanılan teknik, pratik olarak kullanımı mümkün bir yöntemdir ve temporomandibular eklem protezlerinin etkilerinin incelenmesinde, hatta yeni temporomandibular eklem protezleri dizayn edilmesinde kullanılabilir.
Purpose of this study was to evaluate clinical and kinematical outcomes of degenerative temporomandibular joint dysfunction (osteoarthritis) patients before and after metal fossa and eminence partial joint reconstruction. In the proposed study 16 female and 1 male patients (18 joints) under went surgical treatment with metal fossa-eminence hemi-joint prosthesis. Visual analog patient questionnaires were used to evaluate the subjective outcomes. Objective outcomes were evaluated by using a special technique, combining electromagnetic tracking system with CT images using custom made dental plates, developed for this project. Mandibular kinematics was recorded pre and post surgically during maximal mouth opening and condylar and mandibular incisor motion was calculated. While operated condyles served as the study groups, un-operated condyles were used as the control group. Paired t-test was used to evaluate the statistical analysis of the collected data by using SAS 8.2 software. Decrease in pain levels and increase in functional outcomes were recorded by patient questionnaires after the surgical treatment. Additionally mandibular incisor range of motion showed a statistically significant increase following surgery. Also a deviation to the operated side was noted for the mandibular incisors after surgery. Motion of the un-operated condyles didn?t show a statistically significant change, however operated condyle motion was reduced significantly. This difference between the operated vs un-operated side could be explained by the decrease in inferior vector of the operated side condyle motion. As a result; changing the structure of fossa and eminence affected the magnitude and direction of condyle motion. Authors suggest that the proposed technique used in this study was practical tool that could be used in further evaluation and development of temporomandibular joint prosthesis.
Purpose of this study was to evaluate clinical and kinematical outcomes of degenerative temporomandibular joint dysfunction (osteoarthritis) patients before and after metal fossa and eminence partial joint reconstruction. In the proposed study 16 female and 1 male patients (18 joints) under went surgical treatment with metal fossa-eminence hemi-joint prosthesis. Visual analog patient questionnaires were used to evaluate the subjective outcomes. Objective outcomes were evaluated by using a special technique, combining electromagnetic tracking system with CT images using custom made dental plates, developed for this project. Mandibular kinematics was recorded pre and post surgically during maximal mouth opening and condylar and mandibular incisor motion was calculated. While operated condyles served as the study groups, un-operated condyles were used as the control group. Paired t-test was used to evaluate the statistical analysis of the collected data by using SAS 8.2 software. Decrease in pain levels and increase in functional outcomes were recorded by patient questionnaires after the surgical treatment. Additionally mandibular incisor range of motion showed a statistically significant increase following surgery. Also a deviation to the operated side was noted for the mandibular incisors after surgery. Motion of the un-operated condyles didn?t show a statistically significant change, however operated condyle motion was reduced significantly. This difference between the operated vs un-operated side could be explained by the decrease in inferior vector of the operated side condyle motion. As a result; changing the structure of fossa and eminence affected the magnitude and direction of condyle motion. Authors suggest that the proposed technique used in this study was practical tool that could be used in further evaluation and development of temporomandibular joint prosthesis.
Açıklama
Anahtar Kelimeler
Temporomandibular eklem osteoartrit, Temporomandibular joint osteoarthritis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Baltalı, E. (2007). Temporomandibular eklem osteoartritli hastaların cerrahi öncesi ve sonrası kinematik değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış doktora tezi, Konya.
