Temporo-mandibular joint (TMJ) ankylosis is characterized by a decreased mouth opening which affects mastication, speech, and facial aesthetic. Interpositional arthroplasty using autologous tissue is accepted treatment for TMJ Ankylosis; however, harvesting autologous tissue is associated with additional morbidity. In this article we report our results of silicon interpositional arthroplasty for TMJ ankylosis. 20 patients with TMJ ankylosis were included in the study. All patients underwent standard operative procedure using preauricular incision for release of TMJ ankylosis by excision of at least 1 cm of bony block and insertion of 2 cm thick silicon block in the joint space. Postoperatively early mobilization of TMJ was advised from 3rd day onwards. Post operative result was evaluated by assessing the mouth opening as inter incisor distance (IID). 20 patients (27 joints) of TMJ ankylosis were included in the study. There were 8 male and 12 female patients with age ranged from 3–35 years. According to Sawhney classification bony ankylosis was present as Type-IV (n = 13 joints), Type-III (n = 12 joints) and Type-II (2 joints). Preoperative mean IID was 7.15 mm and post operative mean IID was 43.5. There was no facial nerve paresis, malocclusion or recurrence but infection and extrusion of implant occurred in 1 case each. Silicon interpositional arthroplasty is an effective procedure for the treatment of TMJ Ankylosis; as it restores mouth opening and function, maintains the vertical ramus height, and prevents re-ankylosis without any donor site morbidity.
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Chidzonga MM (1999) Temporomandibular joint ankylosis: review of thirty-two cases. Br J Oral Maxillofac Surg 37:123–126
Kent JN, Zide MF (1984) Wound healing: bone and biomaterials. Otolaryngol Clin North Am 17:273–319
Laskin DM (1978) Role of the meniscus in the etiology of posttraumatic temporomandibular joint ankylosis. Int J Oral Surg 7:340–345
Sidebottom AJ, Salha R (2013) Management of the temporomandibular joint in rheumatoid disorders. Br J Oral Maxillofac Surg 51:191–198
Sawhney CP (1986) Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg 77:29–38
Kaban LB, Bouchard C, Troulis MJ (2009) A protocol for management of temporomandibular joint ankylosis in children. J Oral Maxillofac Surg 67:1966–1978
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 87:166–169
Mehrotra D, Pradhan R, Mohammad S, Jaiswara C (2008) Random control trial of dermis-fat graft and interposition of temporalis fascia in the management of temporomandibular ankylosis in children. Br J Oral Maxillofac Surg 46:521–526
Sidebottom AJ (2008) Guidelines for the replacement of temporomandibular joints in the United Kingdom. Br J Oral Maxillofac Surg 46:146–147
Mehrotra D, Dhasmana S, Kumar S (2009) Management of temporomandibular ankylosis with temporal fascia interposition arthroplasty and distraction osteogenesis: report of 30 cases. J Long Term Effects Medical Implants 19:139–148
Ma J, Liang L, Jiang H, Gu B (2015) GapArthroplasty versus interpositional arthroplasty for temporomandibular joint ankylosis: a meta- analysis. PLoS ONE 10(5):e0127652
Feinberg SE, Larsen PE (1989) The use of a pedicled temporalis muscle-pericranial flap for replacement of the TMJ disc: preliminary report. J Oral Maxillofac Surg 47:142–146
Erdem E, Alkan A (2001) (2001)“The use of acrylic marbles for interposition arthroplasty in the treatment of temporomandibular joint ankylosis: follow-up of 47 cases”. Int J Oral Maxillofac Surg 30:32–36
Chossegros C, Guyot L, Cheynet F, Blanc JL, Cannoni P (1999) Full thickness skin graft interposition after temporomandibular joint ankylosis surgery. A study of 31 cases. Int J Oral Maxillofac Surg 28:330–334
Pogrel MA, Kaban LB (1990) The role of the temporalis fascia and muscle flap in temporomandibular surgery. J Oral Maxillofac Surg 48:14–19
Narang R, Dixon RA (1975) Temporomandibular joint arthroplasty with fascia lata. Oral Surg 39:45–50
Kent JN, Misiek DJ (1994) Controversies in disc and condyle replacement for partial and total temporomandibular joint reconstruction. In: Worthington P, Evans JR (eds) Controversies in oral and maxillofacial surgery. WB Saunders, Philadelphia, pp 397–435
Ohara K, Nakamura K, Ohta E (1997) Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plastic Reconstr Surg 99:1030–1036
Wolford LM, Pitta MC, Reiche-Fischel O, Franco PF (2003) TMJ Concepts/techmedica custom-made TMJ total joint prosthesis: 5-year follow-up study. Int J Oral Maxillofac Surg 32:268–274
Lindqvist C, Pihakari A, Tassanen A et al (1986) Autogenous costochondral grafts in temporomandibular joint arthroplasty. J Oral Maxillofac Surg 14:143–149
Guyuron B, Lassa CI (1992) Unpredictable growth pattern of costochondral graft. Plast Reconstr Surg 90:880–886
Rajurkar SG, Makwana R, Ranadive P, Deshpande MD, Nikunj A, Jadhav D (2017) Use of temporalis fascia flap in the treatment of temporomandibular joint ankylosis: A clinical audit of 5 years. Contemp Clin Dent 8:347–351
Omura S, Aoki S, Fujita K (1997) Surgical management of bilateral complete bony ankylosis of the temporomandibular joint: a case report. Br J Oral Maxillofac Surg 35:297–299
Ortak T, Ulusoy MG, Sungur N, Pensöz O, Ozdemir R, Kilinç H (2001) Silicon in temporomandibular joint ankylosis surgery. J Craniofac Surg 12:232–236
Kalra GS, Kakkar V (2011) Temporomandibular joint ankylosis fixation technique with ultra thin silicon sheet. Indian J Plast Surg 44:432–438
Park MW, Eo MY, Seo BY, Nguyen TTH, Kim SM (2019) Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients. Maxillofac Plast Reconstr Surg 41:18
Danda AK, Ramkumar S, Chinnaswami R (2009) Comparison of gap arthroplasty with and without a temporalis muscle flap for the treatment of ankylosis. J Oral Maxillofac Surg 67:1425–1431
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Agarwal, P., Singh, M.P., Tiwari, S. et al. Silicon Interpositional Arthroplasty for Temporo-mandibular Joint Ankylosis. Indian J Otolaryngol Head Neck Surg 73, 78–84 (2021). https://doi.org/10.1007/s12070-020-02063-w
- Temporo-mandibular joint ankylosis
- Silicon interpositional arthroplasty