Edward Chengchuan KO
Kaban’s protocol via preauricular approach has been the protocol for treating TMJ ankylosis for a long time though all roads lead to Rome.
In 2009, we published a paper titled as “Intraoral approach for arthroplasty for correction of TMJ ankylosis” in the international journal of Oral and Maxillofacial Surgery. This technique is originally innovated by our great master Professor Steve Sheng-Tsung Lai. As in his original design, the periosteum overlying the outer surface of the mandibular ramus is reflected, and the bur was used to create the gap from the outer surface of the ramus. Meticulous retraction for protection is the top priority during the surgical procedure.
Changes happen with the advent of piezo and 3D imaging. I would like to share my limited experience here regarding the medial approach to mandibular condyle for intraoral TMJ Gap Arthroplasty by using Piezo and surgical guide. The long shank piezo blade (ACTEON® ) and the precise surgical guide really shift the paradigm and shorten the period of surgery.
Reference
Int J Oral Maxillofac Surg. 2009 Dec;38(12):1256-62.doi: 10.1016/j.ijom.2009.07.016.Epub 2009 Sep 3.
