Surgical correction of ankylosed TMJ in a child: case report
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CASE REPORT
Surgical correction of ankylosed TMJ in a child: case report Gustavo Amaral Lauand 1 & Daniela Meneses-Santos 1 & Flávio Teixeira Santos 1 & Ricardo Pedro da Silva 1 & Cristiano Elias Figueiredo 1 & Claudia Jordão Silva 1 & Marcelo Caetano Parreira da Silva 1 Received: 16 January 2020 / Accepted: 4 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The temporomandibular joint (TMJ) ankylosis describes the bone or fibrous adhesion of the TMJ components, with functional impairment. The present report shows the surgical correction the TMJ ankylosis due to a condyle fracture in a child. A 12-yearold patient, female, attended to the Oral and Maxillofacial Surgery Department of the Clinical Hospital/Federal University of Uberlândia, showing severe mouth opening limitation (9 mm) and history of bilateral condyle fracture and symphysis fracture. The right TMJ ankylosis was diagnosed, removed, reshaped, and repositioned to form the reshaped condyle, by the sliding reconstruction of the condyle using posterior border of mandibular ramus and myofascial interposition of the temporal fascia. Five months of follow-up showed mouth opening of 44 mm maintained after 2 years, without complaints. The surgical treatment of the TMJ ankylosis is needed for the reestablishment of the immediate function; however, the patient must be watched until the end of development. Keywords Trauma . Temporomandibular joint ankylosis . Child
Introduction The temporomandibular joint (TMJ) ankylosis is the result of the fibrous or bone fusion between the condylar head and the glenoid fossa [1]. The ankylosis can be related to facial trauma, local or systemic infection, and to systemic conditions, such as ankylosing spondylitis and rheumatoid arthritis [2]. The trauma is the prevalent factor in the TMJ ankylosis, especially in children, due to falls, traffic accidents, and forceps delivery [3]. The condylar fractures in the pediatric and teenager population pose a serious challenge, once the condyle is an important growing center in the developing mandible. The traumatic fracture includes as complications: facial asymmetry, restrict mandible movements, and TMJ derangements and/or ankylosis [4].When in children, the ankylosis plays a serious and disabling condition, resulting in impairment of speech and chewing, lack of oral hygiene, caries, facial and mandibular
* Gustavo Amaral Lauand [email protected] 1
Oral and Maxillofacial Surgery and Traumatology Department, Federal University of Uberlândia, Av. Pará, 1748 - Umuarama, Bloco 4T, Uberlândia, MG 38405-320, Brazil
growing disturbances, malocclusion, and acute airway involvement [5, 6]. The ankylosis of the TMJ can be classified as true ankylosis, result of any condition that may induce fibrous or bone adhesions and pseudoankylosis, which presents mandible movement restriction due to pathologies from outside the TMJ, such as muscle, bone, and neurological disorders [7]. It was first classified by Shawney, in four types (I–IV), based in anatomical data a
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