DISEASE OF THE JAWS : ANKYLOSIS AND CONTRACTURE OF THE LOWER JAW (ANKYLOSIS ET CONTRACTURA MANDIBULAE) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Etiology. Most often occurs as a result of infection in the joint area. Infectious processes in the muscles attached to the jaw may cause scar contracture of the jaw.
The pathogenesis. The infection enters through hematogenous (scarlet fever, typhoid, diphtheria, gonorrhea) or spreads to neighboring areas (otitis media, para-articular abscess, osteomielite temporal bone), or implemented inflicting injury (wounds with melee weapons). Persistent mixing of the jaws, due to ankylosis and texture that arose during the growth of the jaws, causes the delay of the mandible, especially its horizontal branches. The result is a typical bird profile of the person (opistognathus, micrognathia).
Symptoms. Full or partial but persistent mixing of the jaws. When ankylosis of the lack of head movement of the affected joint. When contracture typically installed small scale movement, but found cicatricial contraction of the muscles, often chewing and cheek. Radiograph when ankylosis detects deformation of the joint cavity neustannoi head, sometimes fusion.
Course and complications. Developed ankylosis or contracture is of a stationary nature. Changes are observed mainly in the developing jaws: delayed growth, delayed shedding of the deciduous teeth, improper eruption of permanent teeth, deformation of the bite, atrophy of the masticatory muscles and their antagonists. Complications occur most often in diseases of the teeth, which due to the unavailability may not be subjected to timely and radical treatment. The number of painful complications should be listed as shortness of food.
Typical signs of ankylosis bird's face, a persistent note of the jaw, ankylosis) let you easily diagnose ankylosis of the jaw.
Prediction adversely, because ankylosis and contracture lead to permanent restricted mobility of the mandible and disfiguring the facial deformities.
Operative treatment: in most cases, osteotomy during the ascending Ramus. The primary systematic stretching often yields favorable results in young subjects in the absence of gross anatomic lesions of the muscles. Immediately after the operation of ankylosis or contracture of the need to take measures to prevent the formation of fibrous adhesions in place by the newly formed osteotomy of the joint. To this end the next day it is necessary to resort to mechanical therapy with the aim passive, and then active mobilization of the lower jaw: it does start between the molars and daily production. usual systematic splitting of the jaws. To prevent the return of stiffness this exercise should be recommended to the patient to produce throughout later life as a daily morning exercise. Children can be trying under General anesthesia to push the mouthpiece and down the jaw bloodless way.