TMJ Ankylosis Management: Our Experience
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ORIGINAL ARTICLE
TMJ Ankylosis Management: Our Experience Satyapriya Shivakotee1 • Col Suresh Menon1 S. Archana2
•
M. E. Sham2 • Veerendra Kumar2
•
Received: 30 July 2019 / Accepted: 23 September 2019 Ó The Association of Oral and Maxillofacial Surgeons of India 2019
Abstract Aim 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. Results 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 & Col Suresh Menon [email protected] M. E. Sham [email protected] Veerendra Kumar [email protected] S. Archana [email protected] 1
Gangtok, India
2
Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bangalore, India
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. Conclusion 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. Keywords Temporomandibular joint ankylosis Temporalis fascia flap Interpositional arthroplasty
Introduction Temporomandibular joint ankylosis (TMA) is a highly distressing condition in which the temporomandibular joint (TMJ) is replaced by scar tissue. The TMA can be classified using a combination of location (intraarticular or extraarticular) [1], type of tissue involved (bone, fibrous or fibro-osseous) [2] and extent of fusion (complete or incomplete). TMA partially or totally prevents the patient from opening his or her mouth. This disabling condition causes speech impairment, difficulty with mastication, poor oral hygiene and abnormalities of facial growth, generating significant psychological stress. TMA is most frequently associated with trauma, but local or systemic infection, tumours, degenerative diseases, intraarticular injection of corticosteroid, forceps delivery and complication of previous TMJ surgery have also been implicated. The common causes are trauma a
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