Reda Fouad Elgazzar BDS, MSc, PhD, FRCDC (C.), RCPS (Glasg.)1*, Ahmed Almuzayyen2
1Department of Oral and Maxillofacial Surgery, Dental Diagnostic & Surgical Sciences, Manitoba, Canada
2OMS Resident College of Dentistry, University of Manitoba, Canada
*Corresponding author: Reda Fouad Elgazzar BDS, MSc, PhD, FRCDC (C.), RCPS (Glasg.), Associate Prof., Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Dental Diagnostic & Surgical Sciences D343 -790 Bannatyne Ave. Winnipeg, Manitoba, Canada. Tel: +12047893634; Fax: +12042723077; Email: email@example.com
Received Date: 19 January, 2018; Accepted Date: 05 February, 2018; Published Date: 12 February, 2018
The main objective of this communication was to introduce a useful tool, OptraDam® plus (Ivoclar vivadent clinical), for sealing the mouth and facilitating jaw manipulation during TMJ surgery including arthroscopy and arthroplasty. Optradam provided an easy access to the mouth, while keeping the TMJ field isolated from oral flora. It protects the lips, tongue and teeth during jaw manipulation, and it was found to be cost and time effective.
2. Keywords: Jaw Manipulations; Optradam; Oral flora; TMJ Surgery
Temporomandibular Joint Dysfunctions (TMD) are group of disorders affecting the ginglymoarthrodial joint of the mandible and related structures. These disorders can be categorised as myofascial in origin, derangement of the intra-articular disc or related to systemic condition such as osteoarthritis . Non- surgical and surgical modalities have been implemented for the management of TMD including arthroscopy  and arthroplasty . In our OMS unit both TMJ arthroscopy and arthroplasty are performed at the operating room under general anesthetic. These two procedures involve preparing the preauricular skin with Betadine and drape in the usual standard sterile fashion. One of the technical challenges in performing such TMJ procedures is the assistant’s role in holding the mandible, via the mouth, for frequent jaw manipulation which deemed to be difficult while maintaining intact drape and sterile environment. To tackle this problem, some surgeons have modified a urology penile dressing and used it to keep the mouth flora isolated from the surgical sterile field, we found this more time consuming and may lead to saliva and secretion contamination during surgery. OptraDam® plus (Ivoclar vivadent clinical) is a rubber dam device with a flexible rim, used by dentist, to accommodate the lip oral mucosa and provide dry field for dental restorative or root canal procedure. The efficacy of OptraDam® in isolating the oral environment from the procedure field was tested and reported to be superior compared to other rubber dam modalities . In our practice at University of Manitoba, Canada we have employed OptraDam® in TMJ arthroscopy and arthroplasty procedures (Figure 1).
OptraDam was placed after patient intubation and just before prepping
and draping the patient. The use of OptraDam provided easy access to jaw
manipulation, protection of teeth, tongue and lips and prevented cross contamination
with the oral flora. We have found it
to be a handy flexible tool that is relatively cheaper and time efficient. We
found two main limitations for its application: one is that OptraDam contains
natural rubber and should not be used in patients with latex allergy; second,
when arthroscopy or arthrocentesis procedures done under intravenous sedation
and local anaesthetic as an office procedure, on a mouth breathing patient.
Figure 1: Optradam was easily inserted in the labial and buccal vestibule just after nasal intubation, and ready for use after prepping and draping.
Citation: Elgazzar RF, Almuzayyen A (2018) Optradam, a Dentist Tool, Utilized for Proper Jaw Manipulation During TMJ Arthroscopy and Arthroplast. Otolaryngol Curr Trends: JOCT-113. DOI: 10.29011/JOCT-113. 000013