INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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Unilateral Cleft Lip

SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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Bilateral Cleft Lip

SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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Cleft Palate

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DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD
SDM
DHARWAD

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Secondary Palatal Repair:Tongue Flaps

SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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SDM
DHARWAD

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Oral Cancer – Radial Forearm Free Flap

SDM
DHARWAD

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Oral Cancer – Radial Forearm Free Flap

SDM
DHARWAD

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Oral Cancer – Anterolateral Thigh Flap

SDM
DHARWAD

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Fibula Osteocutaneous Free Flap

SDM
DHARWAD

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Contour Deformity - Face
De-epithelialized Free Groin Flap

SDM
DHARWAD

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T.M.Joint Ankylosis
Total Rehabilitation

Prof. C. Bhasker Rao
Craniofacial Surgery & Research Centre
S.D.M. College of De...
T.M.Joint Ankylosis
Dissertations
1993 - 2002
“Gap arthroplasty in the treatment of T.M. Joint Ankylosis”
- Dr. G. Rajasek...
T.M.Joint Ankylosis
Dissertations
1993 - 2002
“Developmental mechanisms in T.M. Joint Ankylosis”
- Study using C.T. Scan D...
T.M.Joint Ankylosis
Publications
Salins P.C. et al. Soft and Hard tissue correction
of facial deformity associated with bi...
T.M.Joint Ankylosis
Significance ?
• Still common in Asia
• Disabling condition
• Affects growth

SDM
DHARWAD

www.indiand...
T.M.Joint Ankylosis

Union between the two articulating
surfaces of the joint
SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Types ?
Fibrous

/

Unilateral

SDM
DHARWAD

/

Bony

Bilateral

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T.M.Joint Ankylosis
Causes ?

• Infection
• Trauma

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Infection
• Within the joint
•Vicinity of the joint

• Haematogenic
SDM
DHARWAD

www.indiandentalacade...
T.M.Joint Ankylosis
Trauma
• Birth trauma
• Forceps delivery
• Condylar fractures

SDM
DHARWAD

www.indiandentalacademy.co...
T.M.Joint Ankylosis
Sequelae ?
Direct
Unable to open the mouth
Indirect
Poor oral hygiene
Abnormal feeding habits
Prone fo...
T.M.Joint Ankylosis
Unilateral Ankylosis Effects on Growth
• Fullness of affected side
• Flat normal side
• Deviation of m...
T.M.Joint Ankylosis
Bilateral Ankylosis Effects on Growth

• Retruded chin

• Bird face appearance
SDM
DHARWAD

www.indian...
T.M.Joint Ankylosis
Psycho – Sociological problem ?

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Patients Experience?

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Patients Experience?
Ridiculed by schoolmates
Sympathetic attitude at college
Eating in restaurants an...
T.M.Joint Ankylosis
Diagnosis - Clinical

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Diagnosis - Imaging

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Diagnosis - Imaging

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Unsuccessful Management in the Past

• Forcible Distraction
• Orthodontic appliances

SDM
DHARWAD

www...
T.M.Joint Ankylosis
Successful Management
• Condylectomy
• Gap arthroplasty
• Inter positional arthroplasty
• Costochondra...
T.M.Joint Ankylosis
Surgical Approaches

End-aural
SDM
DHARWAD

Al-Kayat Bramley
www.indiandentalacademy.com
T.M.Joint Ankylosis
Condylectomy
Condyle is removed by sectioning at the neck
• Fibrous ankylosis
• Bony ankylosis where c...
T.M.Joint Ankylosis
Gap Arthroplasty
Bony Ankylosis
A piece of bone from the ankylosed mass is
removed to create the gap

...
T.M.Joint Ankylosis
Gap Arthroplasty

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Inter Positional Arthroplasty
Materials interposed to prevent bony contact
• Temporal fascia
• Tempora...
T.M.Joint Ankylosis
Inter Positional Arthroplasty
Temporalis muscle & fascia

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis
Costochondral Grafts Indicated
In Children

• Maintains height of ramus
• Further growth of condyle?

...
T.M.Joint Ankylosis
Surgeons Perspective
Total Rehabilitation
• Release
• Reconstruction

SDM
DHARWAD

www.indiandentalaca...
T.M.Joint Ankylosis

SDM
DHARWAD

www.indiandentalacademy.com
T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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T.M.Joint Ankylosis

SDM
DHARWAD

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Thank you
For more details please visit
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Cleft talk (nx power lite) /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Cleft talk (nx power lite) /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. SDM DHARWAD www.indiandentalacademy.com
  3. 3. SDM DHARWAD www.indiandentalacademy.com
  4. 4. SDM DHARWAD www.indiandentalacademy.com
  5. 5. SDM DHARWAD www.indiandentalacademy.com
  6. 6. SDM DHARWAD www.indiandentalacademy.com
  7. 7. SDM DHARWAD www.indiandentalacademy.com
  8. 8. SDM DHARWAD www.indiandentalacademy.com
  9. 9. SDM DHARWAD www.indiandentalacademy.com
  10. 10. SDM DHARWAD www.indiandentalacademy.com
  11. 11. SDM DHARWAD www.indiandentalacademy.com
  12. 12. SDM DHARWAD www.indiandentalacademy.com
  13. 13. Unilateral Cleft Lip SDM DHARWAD www.indiandentalacademy.com
  14. 14. SDM DHARWAD www.indiandentalacademy.com
  15. 15. SDM DHARWAD www.indiandentalacademy.com
  16. 16. SDM DHARWAD www.indiandentalacademy.com
  17. 17. SDM DHARWAD www.indiandentalacademy.com
  18. 18. SDM DHARWAD www.indiandentalacademy.com
  19. 19. SDM DHARWAD www.indiandentalacademy.com
  20. 20. SDM DHARWAD www.indiandentalacademy.com
  21. 21. SDM DHARWAD www.indiandentalacademy.com
  22. 22. SDM DHARWAD www.indiandentalacademy.com
  23. 23. Bilateral Cleft Lip SDM DHARWAD www.indiandentalacademy.com
  24. 24. SDM DHARWAD www.indiandentalacademy.com
  25. 25. SDM DHARWAD www.indiandentalacademy.com
  26. 26. SDM DHARWAD www.indiandentalacademy.com
  27. 27. Cleft Palate SDM DHARWAD www.indiandentalacademy.com
  28. 28. SDM DHARWAD www.indiandentalacademy.com
  29. 29. SDM DHARWAD www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com SDM DHARWAD
  31. 31. SDM DHARWAD www.indiandentalacademy.com
  32. 32. Secondary Palatal Repair:Tongue Flaps SDM DHARWAD www.indiandentalacademy.com
  33. 33. SDM DHARWAD www.indiandentalacademy.com
  34. 34. SDM DHARWAD www.indiandentalacademy.com
  35. 35. SDM DHARWAD www.indiandentalacademy.com
  36. 36. Oral Cancer – Radial Forearm Free Flap SDM DHARWAD www.indiandentalacademy.com
  37. 37. Oral Cancer – Radial Forearm Free Flap SDM DHARWAD www.indiandentalacademy.com
  38. 38. Oral Cancer – Anterolateral Thigh Flap SDM DHARWAD www.indiandentalacademy.com
  39. 39. Fibula Osteocutaneous Free Flap SDM DHARWAD www.indiandentalacademy.com
  40. 40. Contour Deformity - Face De-epithelialized Free Groin Flap SDM DHARWAD www.indiandentalacademy.com
  41. 41. T.M.Joint Ankylosis Total Rehabilitation Prof. C. Bhasker Rao Craniofacial Surgery & Research Centre S.D.M. College of Dental Sciences & Hospital Dharwad, Karnataka, India. SDM DHARWAD www.indiandentalacademy.com
  42. 42. T.M.Joint Ankylosis Dissertations 1993 - 2002 “Gap arthroplasty in the treatment of T.M. Joint Ankylosis” - Dr. G. Rajasekhar “Ankylosis of Craniomandibular Articulation” “Effects on Skull base and midfacial growth”. - Dr. Reza Soltanian “An investigation into probable causes of recurrence after gap arthroplasty” - Dr. Sony Jacob “Non osseous components of T.M. Joint Ankylosis related deformity” - A Multifactorial analysis. - Dr. Sunil Dixit SDM DHARWAD www.indiandentalacademy.com
  43. 43. T.M.Joint Ankylosis Dissertations 1993 - 2002 “Developmental mechanisms in T.M. Joint Ankylosis” - Study using C.T. Scan Data and Rabbit Model. - Dr. Mahindra “Morphometric basis for correction of secondary mandibular deformities in unilateral T.M. Joint Ankylosis”. - Dr. Bhushan Jayade “Ankylosis of T.M. Joint – “Long term evaluation in post surgical patients” - Dr. Taranjit SDM DHARWAD www.indiandentalacademy.com
  44. 44. T.M.Joint Ankylosis Publications Salins P.C. et al. Soft and Hard tissue correction of facial deformity associated with bilateral T.M. Joint Ankylosis. Int. J. Oral Maxillofac Surg. 1998, 27: 422 – 424. SDM DHARWAD www.indiandentalacademy.com
  45. 45. T.M.Joint Ankylosis Significance ? • Still common in Asia • Disabling condition • Affects growth SDM DHARWAD www.indiandentalacademy.com
  46. 46. T.M.Joint Ankylosis Union between the two articulating surfaces of the joint SDM DHARWAD www.indiandentalacademy.com
  47. 47. T.M.Joint Ankylosis Types ? Fibrous / Unilateral SDM DHARWAD / Bony Bilateral www.indiandentalacademy.com
  48. 48. T.M.Joint Ankylosis Causes ? • Infection • Trauma SDM DHARWAD www.indiandentalacademy.com
  49. 49. T.M.Joint Ankylosis Infection • Within the joint •Vicinity of the joint • Haematogenic SDM DHARWAD www.indiandentalacademy.com
  50. 50. T.M.Joint Ankylosis Trauma • Birth trauma • Forceps delivery • Condylar fractures SDM DHARWAD www.indiandentalacademy.com
  51. 51. T.M.Joint Ankylosis Sequelae ? Direct Unable to open the mouth Indirect Poor oral hygiene Abnormal feeding habits Prone for snoring Effect on growth SDM DHARWAD www.indiandentalacademy.com
  52. 52. T.M.Joint Ankylosis Unilateral Ankylosis Effects on Growth • Fullness of affected side • Flat normal side • Deviation of mandible to affected side SDM DHARWAD www.indiandentalacademy.com
  53. 53. T.M.Joint Ankylosis Bilateral Ankylosis Effects on Growth • Retruded chin • Bird face appearance SDM DHARWAD www.indiandentalacademy.com
  54. 54. T.M.Joint Ankylosis Psycho – Sociological problem ? SDM DHARWAD www.indiandentalacademy.com
  55. 55. T.M.Joint Ankylosis Patients Experience? SDM DHARWAD www.indiandentalacademy.com
  56. 56. T.M.Joint Ankylosis Patients Experience? Ridiculed by schoolmates Sympathetic attitude at college Eating in restaurants an embarrassment No friends Loneliness helped in studies Parents were helpful Embarrassment at public gatherings www.indiandentalacademy.com SDM DHARWAD
  57. 57. T.M.Joint Ankylosis Diagnosis - Clinical SDM DHARWAD www.indiandentalacademy.com
  58. 58. T.M.Joint Ankylosis Diagnosis - Imaging SDM DHARWAD www.indiandentalacademy.com
  59. 59. T.M.Joint Ankylosis Diagnosis - Imaging SDM DHARWAD www.indiandentalacademy.com
  60. 60. T.M.Joint Ankylosis Unsuccessful Management in the Past • Forcible Distraction • Orthodontic appliances SDM DHARWAD www.indiandentalacademy.com
  61. 61. T.M.Joint Ankylosis Successful Management • Condylectomy • Gap arthroplasty • Inter positional arthroplasty • Costochondral grafts SDM DHARWAD www.indiandentalacademy.com
  62. 62. T.M.Joint Ankylosis Surgical Approaches End-aural SDM DHARWAD Al-Kayat Bramley www.indiandentalacademy.com
  63. 63. T.M.Joint Ankylosis Condylectomy Condyle is removed by sectioning at the neck • Fibrous ankylosis • Bony ankylosis where configuration of condyle is seen SDM DHARWAD www.indiandentalacademy.com
  64. 64. T.M.Joint Ankylosis Gap Arthroplasty Bony Ankylosis A piece of bone from the ankylosed mass is removed to create the gap SDM DHARWAD www.indiandentalacademy.com
  65. 65. T.M.Joint Ankylosis Gap Arthroplasty SDM DHARWAD www.indiandentalacademy.com
  66. 66. T.M.Joint Ankylosis Inter Positional Arthroplasty Materials interposed to prevent bony contact • Temporal fascia • Temporalis muscle • Costochondral grafts SDM DHARWAD www.indiandentalacademy.com
  67. 67. T.M.Joint Ankylosis Inter Positional Arthroplasty Temporalis muscle & fascia SDM DHARWAD www.indiandentalacademy.com
  68. 68. T.M.Joint Ankylosis Costochondral Grafts Indicated In Children • Maintains height of ramus • Further growth of condyle? SDM DHARWAD www.indiandentalacademy.com
  69. 69. T.M.Joint Ankylosis Surgeons Perspective Total Rehabilitation • Release • Reconstruction SDM DHARWAD www.indiandentalacademy.com
  70. 70. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  71. 71. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  72. 72. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  73. 73. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  74. 74. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  75. 75. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  76. 76. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  77. 77. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  78. 78. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  79. 79. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  80. 80. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  81. 81. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  82. 82. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  83. 83. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  84. 84. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  85. 85. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  86. 86. T.M.Joint Ankylosis SDM DHARWAD www.indiandentalacademy.com
  87. 87. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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