Intraoral scar release skin grafting

Intraoral scar loosening and skin grafting is used for the surgical treatment of pseudo temporomandibular joint ankylosis. False temporomandibular joint ankylosis, also known as intermaxillary contracture, is a scar between the intermaxillary joints. According to the extent of the lesion, it can be divided into localized and extended type. The former is mainly interstitial fibrous adhesion, which may be accompanied by ossification; the latter lesion has been extended to the mandibular ascending branch and the maxillary nodule or tibia. For bony adhesions, severe cases may be associated with soft tissue defects of the lips and cheeks. The principle of surgical treatment is to loosen the jaw between the jaws, restore the degree of opening, use the skin flap or flap to eliminate the wound and repair the deformed deformity. Curing disease: Indication Intraoral scar loosening and skin grafting is mainly used for localized intermaxillary contracture, which is fibrous or osseous adhesion between the oral vestibule and the superior and inferior alveolar processes. Contraindications Sustained surgery in acute or subacute episodes of inflammatory lesions in the oral cavity. Preoperative preparation 1. Careful clinical examination to determine the extent of scar adhesion and tissue defects. 2. Take the iron position, Xue's X-ray film. Except for the internal and external osseous joints of the temporomandibular joint. 3. Periodontal scaling, cleans the mouth, and prepares the skin for the skin area. 4. Prepare the adhesive film for the skin grafting in the mouth, hard rubber bite jaw pad, etc. Surgical procedure Loosen the scar In the mouth, the affected part is cut along the maximum tension of the scar, and the side is cut while cutting. The open mouth is opened with an opener. The shallow and deep, from front to back, the multi-section is gradually cut and the scar tissue affecting the opening is removed as much as possible. Until the scar contracture is completely loosened, maximize the mouth. 2. Cut out the adhesion bone For those with alveolar bone adhesion, use a bone chisel to open and bite the proliferating bone, and the bone wound surface should be covered with soft tissue as much as possible. 3. Cut the fault skin Cut the medium-thickness skin with a cutting knife on the inside of the thigh, the area should be larger than the wound inside the mouth. 4. Intraoral wound skin grafting After thorough hemostasis, the skin graft was transplanted into the wound surface, and fixed by iodoform gauze wrapping suture method or impression plastic mold method, and then filled with impression glue between the upper and lower dentitions around the skin grafting area. The contralateral molars can be supported by a hard rubber or bite pad to maintain the opening position. complication 1. The grafted skin is poorly grown Mostly due to poor fixation or infection. For those with a small range, the dressing may be filled with iodoform gauze to make the wound heal; if the range is large, it needs to be replanted or repaired with a flap after proper treatment. 2. Intermaxillary contracture recurrence It is related to the failure to adhere to open exercise or skin contraction after surgery.