TMJ Ankylosis Management: Our Experience



Temporomandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance and hygiene. Surgery of TMJ ankylosis needs careful evaluation and planning to yield predictable results. Temporomandibular joint ankylosis is very common among young children. The aim of treatment is not only to treat the movement of the joint but also to prevent relapse.

Materials and Method

In this series, 18 cases of temporomandibular joint ankylosis were treated at our institute from January 2012 to January 2017 with osteoarthrectomy and interpositional arthroplasty. Patients were in the age range of 5–57 years, with 11 males and 7 females and including 8 unilateral and 10 bilateral cases. Duration of ankylosis ranged from less than 2 years to more than 6 years. Seven of the patients were secondarily taken up for correction of their deformities with either orthognathic surgery or distraction osteogenesis.


Good mouth opening was achieved in all the patients with a mean follow-up period of 12 months. The early post-operative mouth opening ranged from 24 to 37 mm. The late post-operative mouth opening ranged from 20 to 33 mm. There was a stress on aggressive physiotherapy for a minimum of 6 months in all our patients.


Interpositional arthroplasty using vascularized temporalis fascia flap is a very reliable method to prevent recurrence of ankylosis, and it also avoids the disadvantages of alloplastic materials as well as nonvascularized autogenous tissues.

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  1. 1.

    Kazanjian Varaztad H (1955) Temporomandibular joint ankylosis with mandibular retrusion. Am J Surg 90(6):905–910

    CAS  Article  Google Scholar 

  2. 2.

    He D, Yang C, Chen M, Zhang X, Qiu Y, Yang X, Li L, Fang B (2011) Traumatic temporomandibular joint ankylosis: our classification and treatment experience. J Oral Maxillofac Surg 69(6):1600–1607

    Article  Google Scholar 

  3. 3.

    Bortoluzzi Marcelo Carlos, Sheffer MAR (2009) Treatment of temporomandibular joint ankylosis with gap arthroplasty and temporal muscle/fascia graft: a case report with five-year follow-up. Rev Odonto Cienc 24(3):315–318

    Google Scholar 

  4. 4.

    Guven O (2008) A clinical study on temporomandibular joint ankylosis in children. J Cranio facial Surg 19(5):1263–1269

    Article  Google Scholar 

  5. 5.

    Karamese M, Duymaz A, Seyhan N, Keskin M, Tosun Z (2013) Management of temporomandibular joint ankylosis with temporalis fascia flap and fat graft. J Cranio Maxillo Fac Surg 41:789–793

    Article  Google Scholar 

  6. 6.

    Bodra P, Sundi A (2017) Interposition arthroplasty using temporal fascia flap for temporomandibular joint ankylosis. Int J Contemp Med Res 4:2454–7379

    Google Scholar 

  7. 7.

    Laskin DM (1978) Role of the meniscus in the etiology of posttraumatic temporomandibular joint ankylosis. Int J Oral Surg 7:340

    CAS  Article  Google Scholar 

  8. 8.

    Kaban LB, Perrott DH, Fisher K (1990) A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 48(11):1145–1151

    CAS  Article  Google Scholar 

  9. 9.

    Rajgopal A, Banerjee PK, Baluria V, Sural A (1983) Temporomandibular joint ankylosis: a report of 15 cases. J Cranio Maxillofac Surg 11:37

    CAS  Article  Google Scholar 

  10. 10.

    Moriconi ES, Popowich LD, Guernsey LH (1986) Alloplastic reconstruction of the temporomandibular joint. Dent Clin North Am 30(2):307–325

    CAS  PubMed  Google Scholar 

  11. 11.

    Abul-Hassan S, Hussain Grace Von, Dras Ascher AMI, Robert D, Acland MD (1986) Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg 77:17–28

    CAS  PubMed  Google Scholar 

  12. 12.

    Mercuri LG (2015) Temporomandibular joint total joint replacement: TMJ TJR—a comprehensive reference for researchers, material scientists and surgeons. Springer, New York

    Google Scholar 

  13. 13.

    Andrade NN, Kalra R, Shetye SP (2012) New protocol to prevent TMJ reankylosis and potentially life threatening complications in triad patients. Int J Oral Maxillofac Surg 41:1495–1500

    CAS  Article  Google Scholar 

  14. 14.

    Rao K, Kumar S, Kumar V, Singh AK, Bhatnagar SK (2004) The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children. J Cranio Maxillofac Surg 32:38–42

    Article  Google Scholar 

Download references



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Correspondence to Col Suresh Menon.

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Shivakotee, S., Menon, C.S., Sham, M.E. et al. TMJ Ankylosis Management: Our Experience. J. Maxillofac. Oral Surg. 19, 579–584 (2020).

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  • Temporomandibular joint ankylosis
  • Temporalis fascia flap
  • Interpositional arthroplasty