Intra-oral vertico sagittal ramus osteotomy for treatment in habitual luxation

악관절질환중 가장 오래전부터 인지되어왔고 치료되어졌던 악관절질환이며 그래서 그에 대한 치료방법도 많이 이루어져왔다. 습관성 악관절탈구의 원인은 악관절의 인대가 느슨해져서 악관절의 전방운동시 그의 제어가 불가능해져서 이루어진다. 이 악관절탈구의 치료방법은 느슨해진 인대에 Scleosing solution의 주입으로부터 악관절의 고정술, condylotomy까지 다양한 방법의 술식이 사용되어져왔다. 각각 술식의 장단점이 노출된 바 일종의 condylotomy로써 IVSRO를 이용하여 치료해본 결과 별다른 문제없이 치유되어 보고하는 바이다.

Acute, recurrrent, and long-standing forward dislocation of the mandible are not common conditions compared with other conditions. Chronic recurrent dislocations of the mandible can be a significant problem. The understanding of the etiologic factors involved and the interrelations of the joint laxity to internal derangements of the disc are significant when considering the multiple factors of the TMJ disorders in general. A lot of literature shows that the treatment of painful condylar hypermobility, subluxation, and dislocation is approached in a rational conservative way utilizing surgical methods when nonsurgical treatment is not effective. In recurrent dislocation of the temporomandibular joint, many ways of treatment were reported such as eminectomy, eminence augmentation, and condylotomy. The final choice of the correct method(s) of tretment depends on a correct diagnosis and an understanding of the etiologic factors. Intra-oral vertical osteotomy is one of the widely used methods in correction of temporomandibular joint recurrent dislocation. But sagging of the TMJ after IVRO results in a bony step between the proximal segment and distal segment, and lateral rotation of the tempormandibular joint in a natural joint position. In this point of view, IVSRO has advantages. And healing is medular-to-medular minimum cortex-to-medular comparison with cortex-to-cortex healing in IVRO. The author thinks that IVSRO in correction of emporomandibular joint recurrent dislocation. The author performed the IVSRO(Choung s Osteotomy) in a habitual TMJ dislocation patient and it lead to good, and favorable post-pperative results in both function and esthetics.