Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Use of Costochondral Graft In Paediatric Temporomandibular Joint Reconstruction – A Systematic Review And Meta-Analysis(university of Manchester, 2024) baheydrah, shahad; Lucy, OmalleyAbstract Background: Costochondral grafts (CCG) have been regarded as the gold standard for temporomandibular joint (TMJ) reconstruction in growing children and young adults, some authors oppose their use citing concerns about growth abnormalities of the graft. Our systematic review and meta-analysis aimed to assess surgical outcomes of using autogenous costochondral Graft (CCG) for TMJ reconstruction in paediatric and growing patients by assessing maximum interincisal opening (MIO), in addition to evaluating the preoperative aetiology of total TMJR and investigating post-operative complications and long-term success rates associated with total TMJR using CCGs in children and adolescents. Methods: A systematic review was conducted following PRISMA guidelines. The following databases were searched: Scopus, Web of Science, MEDLINE via OVID, and CENTRAL via Cochrane Library. Only randomised controlled trials and observational studies including paediatric and adolescent/young adult patients (age ≤ 18 years) with TMJ pathology, trauma, or congenital anomalies undergoing TMJ reconstruction utilising Costochondral Grafts were included. The outcomes evaluated were: Post-operative MIO and complications. Results: Ten studies satisfied all the inclusion criteria. A total number of 193 subjects and 234 grafts in 3 RCTs and 7 observational studies was included in this review. The most reported TMJ defect/preoperative aetiologies reported were Traumatic ankylosis (35%) followed by Infection-related ankylosis (17%) and congenital anomalies (17%). Following CCG reconstruction 55.44% of patients had optimal growth. A total of 44 % of patients had post-operative complications. The graft abnormalities reported were re-ankylosis (36%), undergrowth (26%), overgrowth (21%), and facial asymmetry (17%). Conclusion: The findings demonstrate the effectiveness of TMJ reconstruction using CCGs in improving the MIO in growing patients with acquired and congenerical TMJ deformities. However, our data also suggest that CCGs showed a considerable risk of postoperative complications. Notably, the grafts with medium-thickness cartilage were associated with the least incidence of long-term graft abnormalities.11 0Item Restricted THE ASSOCIATION OF TMJ SOUNDS WITH DIFFERENT DENTAL AND SKELETAL MEASUREMENTS ALONG WITH HEADACHE AND PAIN USING DC/TMD(Saudi Digital Library, 2022-08-20) Alotaibi, Hamdan; Motro, Melih; Alsulaiman, Ahmad; Motro, PelinPurpose: It has been suggested in some studies that certain malocclusion features are related to Temporomandibular Joint (TMJ) clicking, which is a prevalent sign of Temporomandibular Disorders (TMD’s). This study aimed to evaluate different dental and skeletal malocclusion parameters and their relation to TMJ sounds. Also, to examine TMJ sounds with the presence of headache and TMJ pain using Diagnostic Criteria for Temporomandibular Disorders. Materials & Methods: A sample of 460 subjects seeking orthodontic treatment were evaluated using DC/TMD. Dental measures were recorded based on the initial records along with the clinical examination of the DC/TMD. Skeletal measurements were recorded after lateral cephalometric radiographs were traced. All measurements were confirmed before collection by one examiner using all the initial records. Results: The sample was comprised of 283 females and 177 males. Clicking prevalence among the sample was 13%, of which 70% were females. Hispanic and Other group were significantly associated with opening and closing TMJ click. Class III dental was highly significant with TMJ click (OR: 0.35). Females who had headache had higher odds of having headache compared to males. Headache was significantly associated with all TMJ click variables (Open click [OR:10], lateral click [OR:10], self-reported click [OR:4.7]). Moreover, TMJ pain was significant with open click (OR:7.6), lateral click (OR:14.4), and self-reported click (OR:7.7). African-American group had 0.28 odds of having TMJ pain compared to Hispanics and Other. Finally, Males have 0.29 odds of having TMJ pain compared to females. Conclusion: In conclusion TMJ click upon opening and closing, lateral excursion, and self- reported click is highly associated with headache and chronic headache in general with a prevalence higher in females. Pain was highly associated with TMJ click of all sorts, with a higher prevalence in females and the Hispanic and other group. Finally, TMJ click was found more in the Hispanic and other group and class III dental occlusion subjects.8 0