Abstract
Introduction: Temporomandibular joint ankylosis is a debilitating condition leading to problems in mastication, speech, digestion, oral hygiene and even facial appearance. The basic techniques for surgical correction of ankylosis include the gap arthroplasty, joint reconstruction or interpositional arthroplasty. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence.
 Material and Methods: 21 patients of temporomandibular joint ankylosis admitted from 2015 to 2018 in the Department of Plastic Surgery, SMS Hospital, Jaipur. . Diagnosis was based on history and clinical assessment supplemented with orthopantomogram (OPG) and computer tomographic scans. Mouth opening is measured as interincisoral distance using a scale. Intraoperatively, silicon sheet is sutured with the distal part of flap using non absorbable suture in half overlapped fashion with an overlapped portion across the joint space. Preoperative photograph is taken in all patients and serial post operative photograph were taken during their regular follow up
 Results: 21 patients were part of the study (14 males and 7 females). 16 of our patients were post traumatic. Their age ranged from 7 to 55 years. The disease was unilateral in 19 cases and bilateral in 2 cases. The pre-op interincisal mouth opening ranged from 0 to 9 mm. The intra-operative interincisal mouth opening ranged from 28 to 46 mm. There was no immediate complication and no incidence of facial nerve injury. One patient with bilateral congenital TMJ ankylosis had recurrence. Five patients were lost after the initial 1-year follow-up. 
 Conclusion: Use of combined temporoparietal fascia with thin silicon sheet as interpositional arthroplasty provides extra protection in cases of TMJ ankylosis and thereby decreasing the incidence of its recurrence 
 Keyword: Ankylosis, TMJ, Interpositional arthroplasty
Highlights
Introduction: Temporomandibular joint ankylosis is a debilitating condition leading to problems in mastication, speech, digestion, oral hygiene and even facial appearance
Ankylosis of temporomandibular joint (TMJ) refers to adhesion of bones or fibrosis of Joint anatomical components which may lead to loss of function in the joint [1]
TMJ ankylosis is classified into different categories, based on the position, involvement of tissues and the extent of adhesion and rigidity of bones [3]
Summary
Ankylosis of temporomandibular joint (TMJ) refers to adhesion of bones or fibrosis of Joint anatomical components which may lead to loss of function in the joint [1]. This condition leads to reduction of mouth opening and is associated with problems in mastication, speech, digestion, oral hygiene and even facial appearance (2). TMJ ankylosis is classified into different categories, based on the position (intra or extra capsular), involvement of tissues (bony, fibrous or fibro osseous) and the extent of adhesion and rigidity of bones (complete or partial) [3]. Complete removal of fibrous or bony mass is an important step in the treatment of patients with joint ankylosis [5]. Medially, or leaving the medially displaced fractured condyle coupled with non compliance to the post release exercise regimen is the major cause for recurrence
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