Abstract
Purpose
Temporomandibular joint ankylosis is a major disorder, mainly due to trauma and other reasons, which is responsible for the restriction of mandibular functional activities. The scope of the successful surgical correction of temporomandibular joint ankylosis with amniotic membrane is on the membrane’s being an interpositional material which we found not to elicit any host reaction, is capable of functional adaptation, and is very economical. Our purpose is to show the amniotic membrane as a suitable, biocompatible, and interpositional material alternative to the other materials, thereby reducing donor site morbidity.
Methods
A study was conducted in 13 patients with an age range of 10 to 35 years with unilateral and bilateral bony TMJ ankylosis confirmed by clinical and radiological evaluations. Preoperative and postoperative clinical assessments of TMJ functions were done. Amniotic membranes were collected from the tissue bank, sterilized by gamma radiation, and freeze-dried. Then, the prepared amniotic cap (10–15 layers of amniotic membrane) was placed over the condylar head and anchored loosely to the neck and the surrounding tissues with a 3/0 Vicryl suture.
Results
Measurements of postoperative maximum interincisal opening was taken with scale among the 13 patients. Preoperative interincisal distances ranged from 0 to 15 mm, and preoperative and immediate postoperative were 33–45 and 25–32 mm, respectively. Postoperative follow-up of interincisal opening after 1-, 6-, and 12-month intervals was found from 32 to 35 mm. Lateral excursions (left and right), protrusive movements, and functional recovery were all satisfactory.
Conclusion
Amniotic membrane graft as an interpositional material in temporomandibular joint ankylosis can be a good alternative as to prevent reankylosis and recover functionality.
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References
Verneuil A (1860) De la creation d’une fausse articulation par section ou resection partielle de l’os maxillaire infererieur comme moyen de remedier a l’ankylose vraie ou fausse de la machoire inferieur. Arch Gen Med 15:174–5
Güven OA (2000) Clinical study on temporomandibular joint ankylosis. Auris Nasus Larynx 27(1):27–33
Vishwakarma GK, Krishnan R, Khare AK (1981) Use of amnion in infected wounds. Paper presented at the Indian Orthopaedic Association Conference, Srinagar, India, May 1981
Vishwakarma GK, Khare AK (1986) Amniotic arthoplasty for tuberculosis of the hip. A preliminary clinical study. J Bone Joint Surg 68(1):68–74
Toda A, Okabe M, Yoshida T, Nikaido T (2007) The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 105(3):215–28
Molla MR et al (2003) Temporalis muscle flap as an interpositional material in temporomandibular joint ankylosis; surgical experience with four patients. J Bangladesh Orthop Soc 22:1–7
Mehrotra D, Pradhan R, Mohammad S, Kumar S (2011) Complications associated with different surgical modalities for management of temporomandibular ankylosis in a series of 791 cases. Asian J Oral Maxillofac Surg 23(3):122–127
Kaban LB, Perrot DH, Fiscer K (1990) A protocol for the management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 48:1145–51
Sawhney CP (1986) Bony ankylosis of the temporomandibular joint: follow up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg 77:30–7
Mcleod NM, Saeed NR, Hensher R (2001) Internal derangement of temporomandibular joint treated by discectomy and hemiarthoplasty with a Christensen fossa-eminence prosthesis. Br J Oral Maxillofac Surg 39(1):63–66
Omura S, Fujita K (1996) Modification of the temporalis muscle and fascia flap for the management of ankylosis of the temporomandibular joint. J Oral Maxillofac Surg 54:794–795
Waresuddin (2003) A study on interpositional flap for the management of Temporomandibular joint ankylosis: Folded temporalis muscle and fascia. Thesis, Dhaka University (As a requirement in Masters in Surgery Degree), pp 1–58
Volkov MV (1973) Arthoplasty of joints using amniotic membrane. In: Chapchal G (ed) Arthroplasty of the hip: 5th International Symposium 1972 in Nijmegen, Netherland. Georg Thieme, Stutgart
Pogrel MA, Kaban LB (1990) The role of a temporalis fascia and muscle flap in temporomandibular joint surgery. J Oral Maxillofac Surg 48:14–22
Hasan N, Habibullah P, Masoumeh J et al (2008) Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater 15:88–99
Rahman QB, Molla MR, Islam ME (2007) Temporomandibular joint reconstruction using costochondral graft. Mymensingh Med J 16(2):225–229
Cascone P, Agrillo A, Spuntarelli G, Arangio P, Iannetti G (2002) Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distruction. J Craniofac Surg 13:401–9
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Akhter, M., Ahmed, N., Arefin, M.Ru. et al. Outcome of amniotic membrane as an interpositional arthroplasty of TMJ ankylosis. Oral Maxillofac Surg 20, 63–71 (2016). https://doi.org/10.1007/s10006-015-0529-y
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DOI: https://doi.org/10.1007/s10006-015-0529-y