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Is Eminectomy Effective in the Management of Chronic Closed Lock?

PURPOSE: This study assesses the effectiveness of eminectomy in the management of chronic closed lock, refractory to conservative medical management in the largest multi-centred study of its kind in the UK, with a cohort of 167 patients. Temporomandibular mandibular joint disorder affects 30% of adu...

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Detalles Bibliográficos
Autores principales: Shah, Ketan, Brown, Andrew Nicholas, Clark, Robert, Israr, Mohammed, Starr, Donald, Stassen, Leo F. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer India 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954944/
https://www.ncbi.nlm.nih.gov/pubmed/31988567
http://dx.doi.org/10.1007/s12663-019-01216-x
Descripción
Sumario:PURPOSE: This study assesses the effectiveness of eminectomy in the management of chronic closed lock, refractory to conservative medical management in the largest multi-centred study of its kind in the UK, with a cohort of 167 patients. Temporomandibular mandibular joint disorder affects 30% of adults in the UK. Chronic closed lock is a well-documented sub-type. METHOD: A retrospective study of patients with refractory closed lock was carried out, where conservative management had been implemented for a minimum of 6 months. Refractory patients were offered eminectomy at three separate centres over a period from 1995 to 2011. The primary variable was the inter-incisal distance (IID). Other variables included pain, clicking and nerve damage pre- and post-operatively. RESULTS: There were 167 patients across all three centres, 81% of which were female. The mean IID was 23 mm pre-operatively and 37 mm post-operatively. There was a statistically significant association with the primary predictor variable, yielding a p value of < 0.05. Clicking resolved completely post-operatively in 84 patients (58%). Pain subjectively improved in 56% cases. CONCLUSION: Eminectomy is a safe and effective surgical procedure and has a role to play as a second-line surgical option in the management of closed lock after more conservative medical options have failed.