Autogenous Reconstructive Modalities of TMJ Ankylosis-A Retrospective Analysis of 45 Cases.

Abstract

The study reports the authors' experience in managing temporomandibular joint (TMJ) ankylosis in Chennai, India (1995-2006) and compares the surgical modalities used. Forty-five patients (67 joints) were reviewed in this retrospective study. Pre- and post-operative assessment included history, radiological, physical examination, and range of mouth opening. Age, gender, aetiology, joint(s) affected, surgical modality, complications and follow-up periods were evaluated. Various types (fibrous, fibroosseous and bony) of TMJ ankylosis were diagnosed. Trauma was the commonest aetiology. The patients' age range was 2-50years, 51.1% were males and the follow-up period ranged from 14 to 96months. Average mouth opening was significantly increased to 32mm 12months post-operatively. Mouth opening was compared following different interpositional materials like temporalis interpositioning (33mm), costochondral graft (30.6mm) and autograft (30mm). Minor and major complications were encountered in 37.4% of cases, including 6.7% recurrence rate. Early release of TMJ ankylosis; reconstruction of the ramus height with distraction osteogenesis or bone grafting combined with interpositional arthroplasty, followed by vigorous physiotherapy is a successful strategy for the management of TMJ ankylosis.