Digital occlusal splint for condylar reconstruction in children with temporomandibular joint ankylosis

Abstract

Purpose: A costochondral graft (CCG) is usually used for condylar reconstruction in children with temporomandibular joint (TMJ) ankylosis. The aim of the present study was to introduce the application of a digital occlusal splint (DOS) in the assistance of CCG to treat ankylosis and mandibular deviation simultaneously.

Materials and methods: We designed and implemented a retrospective cohort study and enrolled a sample of growing pediatric patients with unilateral TMJ ankylosis and mandibular deviation who were treated for CCG at our department. The predictor variable was preoperative three-dimensional treatment planning and splint construction (DOS) compared with intraoperative treatment planning and splint fabrication (conventional occlusal splint [COS]). The primary outcome variables were the postoperative ramus height and chin deviation correction measured using Proplan CMF, version 1.3 software. The secondary outcome variable was the treatment time. Data from the 2 methods were compared using the Statistical Package for Social Sciences software package, version 13.0.

Results: A total of 8 children, 4 with a COS and 4 with a DOS were included in the present study. The treatment time was significantly longer in the COS group (mean 9.625 hours) than in the DOS group (mean 6.75 hours). The ramus height and chin deviation correction after surgery were more accurate in the DOS group (mean 2.09 mm and 1.29°, respectively) than in the COS group (mean 5.44 mm and 3.27°, respectively), but without significance (P > .05).

Conclusions: The preoperative fabrication of DOSs compared with the intraoperative fabrication of COSs resulted in a shorter treatment time and improved mandibular deviation correction in the treatment of children with unilateral TMJ ankylosis.