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Journal of Maxillofacial and Oral Surgery

, Volume 18, Issue 2, pp 190–196 | Cite as

Temporomandibular Joint Ankylosis Release: 17 Years of Experience with 521 Joints

  • Sonal Anchlia
  • Jigar DhuvadEmail author
  • Jay Chetan Shah
Clinical Paper
  • 49 Downloads

Abstract

Objective

Various surgical techniques to release temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this paper is to report our Institution’s experience regarding the post-surgical outcome of different surgical techniques for the release of ankylosis of the TMJ.

Materials and Methods

The records from our hospital of 386 patients (521 joints) treated for TMJ ankylosis were reviewed. Data analysis included the etiology of TMJ ankylosis, gender distribution, age group, distribution of ankylosis based on location, type, interincisal opening and complications in the perioperative period.

Results

Out of 521 joints, 65.02% were unilateral and 73.89% had bony ankylosis. The mean maximal incisal opening preoperative was 5.4 mm (SD 3.63 mm) and at 1-year follow-up was 36.9 mm (SD 3.3 mm). There was no permanent facial nerve paralysis. However, transient facial nerve paresis was 14.78%. There was an overall recurrence rate of 8.82%.

Conclusion

We conclude that after TMJ ankylosis release with interpositional arthroplasty, reconstruction of the RCU with L ramus osteotomy is the most favorable. This procedure not only causes least complications, but also maintains height of ramus, facilitating surgeries for secondary asymmetry correction.

Keywords

TMJ ankylosis Interpositional arthroplasty Ramus condyle unit reconstruction 

Notes

Acknowledgements

We sincerely thank our former Head of Dept. of GDCH, Ahmedabad, Dr Babu S Parmar for his contribution toward patient’s surgical work in the Department in his tenure.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human Rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and the Declaration of Helsinki of 1975 that was revised in 2000. Written informed consent was obtained from the patient before their inclusion in the study with the approval from ethical committee. The procedure was explained to them regarding the nature and benefit of the study.

References

  1. 1.
    Kaban LB, Perrott DH (1990) A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 48:1145–1151CrossRefGoogle Scholar
  2. 2.
    Kaban LB, Bouchard C, Troulis MJ (2009) A protocol for management of TMJ ankylosis in children. J Oral Maxillofac Surg 67:1966–1978CrossRefGoogle Scholar
  3. 3.
    Kearns G (1999) Subjective and objective assessment of the temporalis myofascial flap in previously operated temporomandibular joints. J Oral Maxillofac Surg 57:1065–1067CrossRefGoogle Scholar
  4. 4.
    Hussein MM (2002) Condylar reconstruction in extensive ankylosis of TMJ in adults using resected coronoid segment as autograft. Egypt Dent J 48:903–908Google Scholar
  5. 5.
    Liu Y, Khada A, Li J, Hu J, Zhu S, Hsu Y, Wang Q, Wang D (2011) Sliding reconstruction of the condyle using posterior border of mandibular ramus in patients with TMJ ankylosis. Int J Oral Maxillofac Surg 40:1238–1245CrossRefGoogle Scholar
  6. 6.
    He D, Ellis E 3rd, Zhang Y (2008) Etiology of temporomandibular joint ankylosis secondary to condylar fractures: the role of concomitant mandibular fractures. J Oral Maxillofac Surg 66:77–84CrossRefGoogle Scholar
  7. 7.
    El-Sheikh MM, Medra AM (1997) Management of unilateral temporomandibular joint ankylosis associated with facial asymmetry. J Craniomaxillofac Surg 25:109–115CrossRefGoogle Scholar
  8. 8.
    Roychoudhury A, Parkash H, Trikha A (1999) Functional restoration by gap arthroplasty in temporomandibular joint ankylosis. A report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:166–169CrossRefGoogle Scholar
  9. 9.
    Zhi K, Ren W, Zhou H, Gao LL, Zhao CH et al (2009) Management of temporomandibular joint ankylosis: 11 years’ clinical experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:687–692CrossRefGoogle Scholar
  10. 10.
    Elgazzar RF, Abdelhady AI, Sada KA, Elshaal MA, Hussain MM, Abdelal SE et al (2010) Treatment modalities of TMJ ankylosis: experience in Delta Nile, Egypt. Int J Oral Maxillofac Surg 39(4):333–342CrossRefGoogle Scholar
  11. 11.
    Raveh J, Vuillemin TH, Ladrach K, Sutter F (1989) Temporomandibular joint ankylosis: surgical treatment and long term results. J Oral Maxillofac Surg 47:900–906CrossRefGoogle Scholar
  12. 12.
    Lee JJ, Worthington P (1999) Reconstruction of the temporomandibular joint using calvarial bone after a failed Teflon-Proplast implant. J Oral Maxillofac Surg 57:457–461CrossRefGoogle Scholar
  13. 13.
    Abdelhady AI (2004) Role of buccal fat pad interposition after temporomandibular joint ankylosis surgery. Egypt Dent J 50:1057–1069Google Scholar
  14. 14.
    Dimitroulis G (2004) The interpositional dermis–fat graft in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg 33:755–760CrossRefGoogle Scholar
  15. 15.
    Qudah M, Qudeimat MA, Al-Maaita J (2005) Treatment of TMJ ankylosis in Jordanian children—a comparison of two surgical techniques. J Craniomaxillofac Surg 33:30–36CrossRefGoogle Scholar
  16. 16.
    Su-Gwan K (2001) Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg 30:189–193CrossRefGoogle Scholar
  17. 17.
    Nitzan DW, Bar-Ziv J, Shteyer A (1998) Surgical management of temporomandibular joint ankylosis type III by retaining the displaced condyle and disc. J Oral Maxillofac Surg 56:1133–1138CrossRefGoogle Scholar
  18. 18.
    Ellis E, Carlson DS (1986) Histologic comparison of the costochondral, sternoclavicular and temporomandibular joints during growth in Macaca Muttata. J Oral Maxillofac Surg 44:312–321CrossRefGoogle Scholar
  19. 19.
    Gunaseelan R (1997) Condylar reconstruction in extensive ankylosis of temporomandibular joint in adults using resected segment as autograft: a new technique. Int J Oral Maxillofac Surg 26(6):405–407CrossRefGoogle Scholar
  20. 20.
    Matsuura H, Miyamoto H, Ishimaru J, Kurita K, Goss AN (2001) Effect of partial immobilization on reconstruction of ankylosis of the temporomandibular joint with an autogenous costochondral graft: an experimental study in sheep. Br J Oral Maxillofac Surg 39:196–203CrossRefGoogle Scholar
  21. 21.
    Sawhney CP (1986) Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg 77:29–38CrossRefGoogle Scholar
  22. 22.
    Saeed NR, Kent JN (2003) A retrospective study of the costochondral graft in TMJ reconstruction. Int J Oral Maxillofac Surg 32:606–609CrossRefGoogle Scholar
  23. 23.
    Medra AM (2005) Follow up of mandibular costochondral grafts after release of ankylosis of the temporomandibular joints. Br J Oral Maxillofac Surg 43:118–122CrossRefGoogle Scholar
  24. 24.
    Kumar P, Rattan V, Rai S (2015) Do costochondral grafts have any growth potential in temporomandibular joint surgery? A systematic review. J Oral Biol Craniofac Res 5(3):198–202CrossRefGoogle Scholar
  25. 25.
    Perrott DH, Umeda H, Kaban LB (1994) Costochondral graft construction/reconstruction of the ramus/condyle unit: long-term follow-up. Int J Oral Maxillofac Surg 23:321CrossRefGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial SurgeryGovt. Dental College and HospitalAhmedabadIndia

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