Temporomandibular Joint (TMJ) Pathologies in Growing Patients: Effects on Facial Growth and Surgical Treatment

Chapter
First Online:

Abstract

There are many temporomandibular joint (TMJ) conditions and pathologies that can be present at birth or develop during the growing years that can adversely affect facial growth and development. Some of these conditions can also cause pain, TMJ and jaw dysfunction, and disability. The mandibular condyles, an integral component of the TMJs, are a primary growth center of the mandible. The TMJs are the foundation and support for jaw position, TMJ and jaw function, occlusion, facial balance, normal facial growth and development, as well as comfort. In the presence of TMJ pathology that affects the condyles, growth may be significantly altered creating dentofacial deformities and treatment outcomes for corrective jaw surgery may be unsatisfactory relative to function, esthetics, occlusion, skeletal stability, and pain if the TMJ pathology is ignored. The most common TMJ disorders affecting growth and development can be divided into two basic categories: condylar hyperplasia (over-development) and condylar under-development or resorption. Predictability of results and limiting correction of the jaw and TMJ-related deformities to one major operation can usually best be achieved by waiting until facial growth is normally complete. Some required surgical procedures may have an adverse affect on subsequent facial growth. There are definite indications for early surgery such as ankylosis, growth center transplants (i.e., rib or sternoclavicular grafts), masticatory dysfunction, tumor removal, airway obstruction, sleep apnea, and psychosocial factors. TMJ and orthognathic surgery can be performed safely and predictably at the same operation. The surgical procedures can be separated into two or more surgical stages, but the TMJ surgery should be done first.

Keywords

Mandibular Condyle Orthognathic Surgery Articular Disk Facial Deformity Anterior Open Bite 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

AI/CT

autoimmune/connective tissue

AICR

Adolescent internal condylar resorption

CH

Condylar hyperplasia

JRA

Juvenile rheumatoid arthritis

MRI

Magnetic resonance imaging

TMJ

Temporomandibular joint

This is a preview of subscription content, log in to check access.

References

  1. Adzuki T, Schroth G, Laeng RH. J Oral Maxillofac Surg. 1996;54:495–9.CrossRefGoogle Scholar
  2. Downie MJ, Wolford LM, Morales-Ryan CA. J Oral Maxillofac Surg. 2001;59:51–5.Google Scholar
  3. Goncalves JR, Cassano DS, Wolford LM, Santos-Pinto A, Marquez IM. J Oral Maxillofac Surg. 2008;66:724–38.PubMedCrossRefGoogle Scholar
  4. Karras SC, Wolford LM, Cottrell DA. J Oral Maxillofac Surg. 1996;54:640–6.PubMedCrossRefGoogle Scholar
  5. Mehra P, Wolford LM. J Oral Maxillofac Surg. 2000;58:95–101.CrossRefGoogle Scholar
  6. Mehra P, Wolford LM. Int J Oral Maxillofac Surg. 2001;30:497–503.PubMedCrossRefGoogle Scholar
  7. Mehra P, Wolford LM, Baran S, Cassano DS. J Oral Maxillofac Surg. 2009;67:1859–72.PubMedCrossRefGoogle Scholar
  8. Mercuri LG. Oral Maxillofac Clin N Am. 2000;12:73–91.Google Scholar
  9. Mercuri LG, Wolford LM, Sanders B, White RD, Hurder A, Henderson W. J Oral Maxillofac Surg. 1995;53:106–15.PubMedCrossRefGoogle Scholar
  10. Mercuri LG, Wolford LM, Sanders B, White RD, Giobbie-Hurder A. J Oral Maxillofac Surg. 2002;60:1440–8.PubMedCrossRefGoogle Scholar
  11. Morales-Ryan CA, Garcia-Morales P, Wolford LM. J Oral Maxillofac Surg. 2002;60:53–9.CrossRefGoogle Scholar
  12. Tompach P, Dodson TB, Kaban LB. Philadelphia: WB Saunders; 2000. pp. 301–15.Google Scholar
  13. Wolford LM. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;83:143–9.PubMedCrossRefGoogle Scholar
  14. Wolford LM. Proc (Bayl Univ Med Cent). 2001;14:246–52.Google Scholar
  15. Wolford LM. J Oral Maxillofac Surg. 2003;61:1198–204.PubMedCrossRefGoogle Scholar
  16. Wolford LM, Cardenas L. Am J Orthod Dentofacial Orthop. 1999;116:667–76.PubMedCrossRefGoogle Scholar
  17. Wolford LM, Cassano DS, Autogenous fat grafts placed around temperomandbular joint (TMJ) total joint prosthesis to prevent heterotopic bone. Sheffman MA (Ed.) Autogenous fat transfer. Springer Verlag, Berlin 2010. Chapter 48, pp. 361–382.Google Scholar
  18. Wolford LM, Morales-Ryan CA, Garcia-Morales P, Perez D. Surgical management of mandibular condylar hyperplasia type 1. Bayl Univ Med Cent Proc. 2009;22:321–329.Google Scholar
  19. Wolford LM, Karras SC. J Oral Maxillofac Surg. 1997;55:245–51.PubMedCrossRefGoogle Scholar
  20. Wolford LM, Mehra P. Proc (Bayl Univ Med Cent). 2000;13:135–8.Google Scholar
  21. Wolford LM, Rodrigues DB. Orthognathic surgery considerations in the young patient and effects on facial growth, Chapter 108. In: Preedy VR, editor. Handbook of growth and growth monitoring in health and disease. London, UK; 2011; pp. xxGoogle Scholar
  22. Wolford LM Cottrell DA, Henry CH. J Oral Maxillofac Surg. 1994a;52:2–10.PubMedCrossRefGoogle Scholar
  23. Wolford LM Cottrell DA, Henry CH. J Oral Maxillofac Surg. 1994b;52:119–28.PubMedCrossRefGoogle Scholar
  24. Wolford LM, Cottrell DA, Karras SC. Proc SMST-94, First International Conference on Shape Memory and Superelastic Technologies, Monterey, CA: MIAS; 1995. pp. 477–82.Google Scholar
  25. Wolford LM, Karras SC, Mehra P. Am J Orthod Dentofac Orthop. 2001a;119:95–101.CrossRefGoogle Scholar
  26. Wolford LM, Karras SC, Mehra P. Am J Orthod Dentofac Orthop. 2001b;119:102–5.CrossRefGoogle Scholar
  27. Wolford LM, Karras SC, Mehra P. J Oral Maxillofac Surg. 2002a;60:356–62.PubMedCrossRefGoogle Scholar
  28. Wolford LM, Mehra P, Franco P. J Oral Maxillofac Surg. 2002b;60:262–3.PubMedCrossRefGoogle Scholar
  29. Wolford LM, Mehra P, Reiche-Fischel O, Morales-Ryan CA, Garcia- Morales P. Am J Orthod Dentofacial Orthop. 2002c;121:136–51.PubMedCrossRefGoogle Scholar
  30. Wolford LM, Pitta MC, Reiche-Fischel, Franco PF. Int J Oral Maxillofac Surg. 2003a;32:268–74.PubMedCrossRefGoogle Scholar
  31. Wolford LM, Reiche-Fischel O, Mehra P. J Oral Maxillofac Surg. 2003b;61:655–60.PubMedCrossRefGoogle Scholar
  32. Wolford LM, Morales-Ryan CA, Garcia-Morales P, Cassano DS. Proc (Bayl Univ Med Cent). 2008;21:248–54.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryTexas A & M University Health Science Center, Baylor College of Dentistry, Private Practice Baylor University Medical CenterDallasUSA
  2. 2.Oral and Maxillofacial SurgeryHospital Santo Antonio das Obras Sociais Irmã Dulce and Private PracticeBahiaBrazil

Personalised recommendations