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Experience gained from using three extra oral approaches to the neck of the mandibular condyle: A comparative study
الخبرة المكتسبة من استخدام ثلاثة أساليب شفوية إضافية لعنق اللقمة الفك السفلي: دراسة مقارنة

Author: Reiadh K. Al-Kamali
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 1 Pages: 604-610
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Surgical treatment of condylar diseases involves some problems concerning the choice of the surgical approach to the condylar neck that provides adequate exposure of the area with the least trauma to the facial nerve and parotid tissue. In this paper, personal experience with the surgical treatment of some mandibular condylar neck problems by the preauricular, submandibular and the retromandibular- transmasseteric approaches is reported.Methods: Over the last 5 years, 52 condylar neck surgeries were carried out on 41 patients to treat 18 cases of condylar neck fractures, 19 cases of plate and bone graft fixation after resection of mandibular tumours and 4 cases of chronic pain and dysfunction of the TMJ. During follow-up, functions of the mandible and facial nerve branches were monitored as does the presence or absence of sialocele or parotid fistula. The appearance of the scar post- surgically and the quality of the access achieved by each type of the approaches to the condylar neck were also appraised.Results: The incidence of apparent postoperative scar appeared most after the preauricular approach to the condylar neck and least after the submandibular approach. Difficulties in management of condylar neck fractures are found more with the preauricular and least with the retromandibular-transmasseteric approaches. Weaknesses in the branches of the facial nerve are noticed in 50% of the preauricular approaches, 6.89% of the retromandibular-transmasseteric approaches, and 47.36% of the submandibular approaches. In all of the patients, this problem lasted for 3-6 weeks to resolve spontaneously thereafter. All the patients in this work suffered limitation of jaw opening in the early postsurgical period. This problem was a transient one and due to pain and muscle spasm. However, persistent limitation of jaw opening is reported in 13.79% of the retromandibular-transmasseteric approaches and 47.36% of the submandibular approaches to the mandibular condyle.Conclusion: Experience has shown that the retromandibular-transmasseteric approach to the condylar neck allows for good anatomical repositioning of the fractured condyle and direct access for precise positioning and fixation of the plate or bone graft to achieve satisfactory mandibular function with the least chance of trauma to the facial nerve and parotid tissues.


Article
Experience in the management of the true ankylosis of the temporomandibular joint: A suggested protocol for treatment
خبرة في إدارة خلل المفصل الصدغي الحقيقي: بروتوكول مقترح للعلاج

Authors: Hundreen M. Ali --- Reiadh K. Al-Kamali
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 1 Pages: 894-901
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: True ankylosis of the temporomandibular joint may be defined as joint surfaces fusion. It can affect the function adversely and when occurs during childhood, it can adversely affect mandibular growth. The treatment is usually surgical, but, unfortunately, poses a significant challenge because of the high recurrence rate. The objective of this paper is to evaluate the outcome of following a definitive protocol in the treatment of temporomandibular joint ankylosis. Methods: Seventy-seven patients, 36 unilateral and 41 bilateral ankylosis (118 ankylosed joints) were diagnosed clinically and radiologically as having true ankylosis of the temporomandibular joint during the period between 2001 and 2013. Resection of the ankylosed bone or horizontal ramus osteoctomy of the affected side with interpositional autogenic or alloplastic material, with possible ipsilateral and/or contralateral coronoidectomy to achieve the definitive interincisal opening of not less than 35mm. Results: The postoperative measurement of interincisal opening of ≥35mm with lateral and protrusive movement was the criteria for success of surgery. Reankylosis occurred in 7 unilateral and 12 bilateral cases. Conclusion: Postoperative jaw opening exercises are crucial for lasting success and failure of patient compliance is the cause of reankylosis.


Article
Arthrocentesis versus conservative treatments for TMJ dysfunctions: A preliminary prospective study
بزل المفصل مقابل العلاجات المحافظة لخلل وظائف المفصل الفكي الصدغي: دراسة مستقبلية أولية

Authors: Reiadh K. Al-Kamali --- Saeed Hameed Saeed
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2014 Volume: 18 Issue: 2 Pages: 739-745
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: The temporomandibular disorders present with a variety of signs and symptoms which include pain in the joint and its surrounding, jaw sounds, limited jaw opening, jaw deviation and headache. The aim of this study was to compare the results and efficacy of arthrocentesis with those of conservative treatments for temporomandibular joint disorders.Methods: In a clinical comparative prospective study, 45 patient of both sexes were enrolled in this study according to inclusion criteria’s. The arthrocentesis group consisted of 22 patients (31 joints). The conservative treatment group consisted of 23 patients (34 joints). For both groups, pretreatment and four months post treatment parameters (visual analogue scale for pain, maximum mouth opening and joint sounds score) were recorded.Results: The results revealed that highly statistically significant difference between all pretreatment and forth months post treatment parameter means for both groups (P < 0.001). Both arthrocentesis and conservative treatments were effective. There was a highly statistical significant difference between the four months post treatment parameter means for both groups (P < 0.001). Arthrocentesis was superior to conservative treatments. The overall success rate was 87.1% for arthrocentesis and 55.9% for conservative treatments.Conclusion: Both conservative treatment and arthrocentesis are effective in the treatment of temporomandibular joint dysfunctions. However, arthrocentesis seems to be superior.


Article
A double blind comparative study of the effect of nimesulide and naproxen on postoperative pain and swelling following periradicular surgery
دراسة مقارنة عمياء مزدوجة لتأثير نيميسوليد ونابروكسين على آلام ما بعد الجراحة وتورم بعد جراحة محيطة بالجذر

Authors: Ahmed A. Haider --- Reiadh K. Al-Kamali --- Dilman Najmaddin Muhammad
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 3 Pages: 508-513
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Pain and swelling are common postoperative complications that occur after periradicular surgery. A double blind comparative study was, therefore, designed to evaluate the effect of nimesulide and naproxen on the postoperative pain and swelling following periradicular surgery on one of the upper anterior teeth.Methods: Sixty patients with a periapical lesion that required periradicular surgery were included in the study. They were divided into three groups according to the type of the postoperative analgesia they are going to administered.Group I: Nimesulide administered group.Group II: Naproxen administered group.Group III: Placebo administered group.Patients of each group were informed about the nature of the study and given the same shape of capsules. They are asked to assess their postoperative pain and swelling for 5 days by using the visual analogue scale (VAS).Results: The results showed that both nimesulide and naproxen are effective in reducing the postoperative pain and swelling following periradicular surgery, and the nimesulide is found better than naproxen in this regard.Conclusion: In this study both nimesulide and naproxen were significantly more effective than their corresponding placebo for reducing postoperative pain and swelling following periradicular surgery, but nimesulide administered group expressed significantly little pain in comparison to naproxen administered group, and the nimesulide administered group showed lesser swelling in the 2nd and 3rd postoperative day than those administered with naproxen.


Article
The Normal Range of Mouth Opening in Kurdish Population and its Correlation to Age, Sex, Height, and Weight
المدى الطبيعي للفم المفتوح عند السكان الأكراد وعلاقته بالسن والجنس والطول والوزن

Authors: Handreen M. Ali --- Reiadh K . Al Kamali --- shahab A. Hamad
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2010 Volume: 14 Issue: 3 Pages: 41-46
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and Objectives: to many dental disciplines, especially oral and maxillofacial surgeons to perform dental treatments and oral surgical procedures comfortably. This study was conducted to estimate the degree of mouth opening and its correlation to sex, age, height and weight.Methods: The maximum mean mouth opening of 1262 Kurdish adult was measured using a calibrated ruler, in addition to body height and weight. Student-t test was used to assess the statistical difference between males and females and Pearson correlation coefficient to assess the correlation between mouth opening and both body height and weight.Results: The mean value of mouth opening was 50.56 mm for males and 48.46 mm for females. The greatest mean mouth opening was noted in the age group of 16-24 and decreased gradually with advanced age. A significant positive correlation was noted between mouth opening and both body height and weight.Conclusions: Mouth opening was higher in males than females in all age groups and decreased gradually with advancing age. It was positively correlated with body height and weight.

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