Advertisement

The Intraoral Vertical Ramus Osteotomy

  • Rebeka G. SilvaEmail author
Chapter

Abstract

The intraoral vertical ramus osteotomy (IVRO) has a distinct advantage over other TMJ surgeries; the joint capsule and intracapsular structures are preserved, and the surgery has a low complication rate. For selected patients with symptomatic anterior disc dislocation, the IVRO is a classic operation that can unload the joint as well as reposition it more favorably under the disc. The new condylar position can be characterized as an increase in the superior joint space dimension and a slightly more anterior angulation of the joint head. Patient selection is important, due to the need to maintain control over the occlusion through the use of maxillomandibular fixation for several weeks.

Keywords

Temporomandibular Condylotomy Internal derangement Osteotomy Ramus 

References

  1. 1.
    Hall HD, Chase DC, Payor LG. Evaluation and refinement of the intraoral vertical subcondylar osteotomy. J Oral Surg. 1975;33(5):333–41.PubMedGoogle Scholar
  2. 2.
    Hall HD, McKenna SJ. Further refinement and evaluation of intraoral vertical ramus osteotomy. J Oral Maxillofac Surg. 1987;45(8):684–8.CrossRefGoogle Scholar
  3. 3.
    Hall HD, Nickerson JW Jr, McKenna SJ. Modified condylotomy for treatment of the painful temporomandibular joint with a reducing disc. J Oral Maxillofac Surg. 1993;51(2):133–42; discussion 143–4.CrossRefGoogle Scholar
  4. 4.
    Limberg A. Treatment of the open-bite by means of plastic oblique osteotomy of the ascending rami of the mandible. Dent Cosmos. 1925;67(12):1191–200.Google Scholar
  5. 5.
    Hall HD. Modification of the modified condylotomy. J Oral Maxillofac Surg. 1996;54(5):548–51; discussion 551–2.CrossRefGoogle Scholar
  6. 6.
    Bell WH, Yamaguchi Y, Poor MR. Treatment of temporomandibular joint dysfunction by intraoral vertical ramus osteotomy. Int J Adult Orthodon Orthognath Surg. 1990;5(1):9–27.PubMedGoogle Scholar
  7. 7.
    Hall HD. The condylotomy procedure. Atlas Oral Maxillofac Surg Clin North Am. 1996;4(2):93–106.CrossRefGoogle Scholar
  8. 8.
    Moses JJ, Sartoris D, Glass R, Tanaka T, Poker I. The effect of arthroscopic surgical lysis and lavage of the superior joint space on TMJ disc position and mobility. J Oral Maxillofac Surg. 1989;47(7):674–8.CrossRefGoogle Scholar
  9. 9.
    Ohnuki T, Fukuda M, Nakata A, Nagai H, Takahashi T, Sasano T, et al. Evaluation of the position, mobility, and morphology of the disc by MRI before and after four different treatments for temporomandibular joint disorders. Dentomaxillofac Radiol. 2006;35(2):103–9.CrossRefGoogle Scholar
  10. 10.
    Israel HA. Modification of the modified condylotomy. J Oral Maxillofac Surg. 1996;54(5):551–2.CrossRefGoogle Scholar
  11. 11.
    Hall HD, Navarro EZ, Gibbs SJ. One- and three-year prospective outcome study of modified condylotomy for treatment of reducing disc displacement. J Oral Maxillofac Surg. 2000;58(1):7–17; discussion 18.CrossRefGoogle Scholar
  12. 12.
    Hall HD, Navarro EZ, Gibbs SJ. Prospective study of modified condylotomy for treatment of nonreducing disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(2):147–58.CrossRefGoogle Scholar
  13. 13.
    Werther JR, Hall HD, Gibbs SJ. Disk position before and after modified condylotomy in 80 symptomatic temporomandibular joints. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(6):668–79.CrossRefGoogle Scholar
  14. 14.
    McKenna SJ, Cornella F, Gibbs SJ. Long-term follow-up of modified condylotomy for internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(5):509–15.CrossRefGoogle Scholar
  15. 15.
    Upton LG. The case for mandibular condylotomy in the treatment of the painful, deranged temporomandibular joint. J Oral Maxillofac Surg. 1997;55(1):64–9.CrossRefGoogle Scholar
  16. 16.
    Nickerson JWJ. The role of condylotomy in the management of temporomandibular disorders. In: Worthington P, Evans JJ, editors. Controversies in oral and maxillofacial surgery. 4th ed. Philadelphia: Saunders; 1993. p. 339–55.Google Scholar
  17. 17.
    Tasanen A, Lamberg MA. Closed condylotomy in the treatment of osteoarthritis of the temporomandibular joint. Int J Oral Surg. 1974;3(3):102–10.CrossRefGoogle Scholar
  18. 18.
    Tasanen A, Jokinen J. Closed condylotomy in the treatment of osteoarthritis of the temporomandibular joint. Clinical and radiographic study. Int J Oral Surg. 1981;10(4):230–5.CrossRefGoogle Scholar
  19. 19.
    Park KR, Kim SY, Park HS, Jung YS. Surgery-first approach on patients with temporomandibular joint disease by intraoral vertical ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(6):e429–36.CrossRefGoogle Scholar
  20. 20.
    Ueki K, Marukawa K, Nakagawa K, Yamamoto E. Condylar and temporomandibular joint disc positions after mandibular osteotomy for prognathism. J Oral Maxillofac Surg. 2002;60(12):1424–32; discussion 1432–4.CrossRefGoogle Scholar
  21. 21.
    Yamauchi K, Takenobu T, Takahashi T. Condylar luxation following bilateral intraoral vertical ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(6):747–51.CrossRefGoogle Scholar
  22. 22.
    Hall HD, Werther JR. Results of reoperation after failed modified condylotomy. J Oral Maxillofac Surg. 1997;55(11):1250–3; discussion 1253–4.CrossRefGoogle Scholar
  23. 23.
    Banks P, Mackenzie I. Criteria for condylotomy: a clinical appraisal of 211 cases. Proc R Soc Med. 1975;68(10):601–3.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Banks P, Mackenzie I. Condylotomy. A clinical and experimental appraisal of a surgical technique. J Maxillofac Surg. 1975;3(3):170–81.CrossRefGoogle Scholar
  25. 25.
    Nickerson JWJ, Veaco NS. Condylotomy in surgery of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 1989;1:303–27.Google Scholar
  26. 26.
    Chen CM, Lai S, Chen KK, Lee HE. Intraoperative hemorrhage and postoperative sequelae after intraoral vertical ramus osteotomy to treat mandibular prognathism. Biomed Res Int. 2015;2015:318270.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Al-Bishri A, Barghash Z, Rosenquist J, Sunzel B. Neurosensory disturbance after sagittal split and intraoral vertical ramus osteotomy: as reported in questionnaires and patients’ records. Int J Oral Maxillofac Surg. 2005;34(3):247–51.CrossRefGoogle Scholar
  28. 28.
    Takazakura D, Ueki K, Nakagawa K, Marukawa K, Shimada M, Shamiul A, et al. A comparison of postoperative hypoesthesia between two types of sagittal split ramus osteotomy and intraoral vertical ramus osteotomy, using the trigeminal somatosensory-evoked potential method. Int J Oral Maxillofac Surg. 2007;36(1):11–4.CrossRefGoogle Scholar
  29. 29.
    Aziz SR, Dorfman BJ, Ziccardi VB, Janal M. Accuracy of using the antilingula as a sole determinant of vertical ramus osteotomy position. J Oral Maxillofac Surg. 2007;65(5):859–62.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Oral and Maxillofacial Surgery, San Francisco VA Health Care SystemUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Private Practice, Dental Implant and Oral Surgery of San FranciscoSan FranciscoUSA

Personalised recommendations