Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification system

Long Xia,Yi Zhang,Yang He,Jingang An,Yingbin Yan,Shuo Chen,E Xiao

doi:10.1038/s41598-019-46519-8

Long Xia, Yi Zhang + Show 5 more

Open Access

https://doi.org/10.1038/s41598-019-46519-8

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Abstract

This study aimed to describe the clinical features of different types of traumatic temporomandibular joint (TMJ) ankylosis. Seventy-one patients with 102 ankylosed joints were retrospectively reviewed and categorized into four groups according to the grades of severity: type I, non-bony ankylosis of the joint with almost-normal joint space; type II, lateral bony ankylosis marked by a normal joint space that coexists with a radiolucent line; type III, complete bony ankylosis of the joint characterized by only a radiolucent line; and type IV, extensive bony ankylosis without any radiolucent line. The period of ankylosis, maximal mouth opening (MMO), rate of complications, and histopathological changes were compared among groups. Intergroup comparison showed significant differences in the clinical features of MMO and the incidence of complications (p < 0.05). Younger trauma patients tended to develop more severe types of ankylosis than older patients. Additionally, long post-trauma periods were related to the development of severe ankylosis. MMO was highly negatively correlated with the severity of ankylosis. Significant differences were noted among the four types of ankylosis. Younger trauma patients with long post-trauma periods tended to develop more severe TMJ ankylosis, experience more complications, and face more challenges in treatment than older patients.

Highlights

Traumatic temporomandibular joint (TMJ) ankylosis refers to the fibrous or bony fusion between the condyle and fossa, which is often caused by condylar fracture
It is important to correctly estimate the severity of TMJ ankylosis in order to accurately evaluate the difficulty of surgery, precisely plan the resection, and assess the amounts of autogenous or alloplastic material required to fill the gap created in gap arthroplasty[11]
Extensive research has focused on determining the ideal algorithm for classification of the severity of TMJ ankylosis[12]

Summary

Introduction

Traumatic temporomandibular joint (TMJ) ankylosis refers to the fibrous or bony fusion between the condyle and fossa, which is often caused by condylar fracture. It usually develops before the age of 10 years[1], but could develop at any age[2]. Patients usually present with limitation of mouth opening and a maximum interincisal distance of 0–20 mm This condition eventually causes aesthetic defects in the face, malocclusion, and facial malformation, during childhood[4]. Our previous study revealed a correlation between mouth opening and the Sawhney class in patients, suggesting that the extent of bony fusion area influences mouth opening[7]. This study aimed to describe the clinical features of different types of TMJ ankylosis as per our proposed classification and validate the correlations between the severity of clinical features and the type of disease

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