Abstract
We have reviewed the clinical and experimental reports regarding interpositional arthroplasty materials in the treatment of temporomandibular joint(TMJ) ankylosis. The aim of this review is to determine what constitutes an ideal interpositional material and whether any of the existing materials reported in the literature provide all requirements of an effective disc substitute following the surgical excision of ankylotic mass. We evaluated these reports in terms of the maximum mouth opening(MMO), aetiology, type of ankylosis, type of graft used, recurrence and other complications. Also we compared the results of the other experimental studies with those of our former experimental study. This was the first report that human amniotic membrane(HAM) had been used as an interposition material. The study has clearly demonstrated that HAM was superior to gap arthroplasty evidenced by vertical, left and right jaw movements in the rabbits clinically. This was supported by histological and radiological investigations, as well. However HAM had the inability to achieve the vertical height of the mandibular ramus, so that a total functional reconstruction was not obtained. In reviewing the literature, it is obvious that there is no ideal interpositional material that provides all the criteria for replacement of a missing articular disc following TMJ discectomy. Although HAM as an interpositional material in tmj ankylosis treatment has not yet been used in human beings, we consider HAM as an interface material with replacing the disc using a cartilage graft might be effective to prevent reankylosis method for treatment of type 1 and 2 of TMJ ankylosis.
Highlights
TMJ ankylosis can be described as a fusion of joint surfaces
Temporalis myofascial flap is referred as a gold standard in the treatment of TMJ ankylosis in the literature, there have been a number of reports that other autogenous grafts including costochondral graft, dermis fat graft, and skin graft or alloplastic materials were suggested as successful and suitable options
We have reviewed the clinical and experimental reports regarding interposition arthroplasty materials used in the treatment of TMJ ankylosis in terms of pre- and postoperative measurements of mouth opening, aetiology, type of graft material, type of ankylosis, recurrence and presence of other complications
Summary
TMJ ankylosis can be described as a fusion of joint surfaces. This condition can lead to chewing, digestion, speech, aesthetic, oral hygienic problems [1,2,3]. Various procedures have described for the treatment of TMJ ankylosis in the literature These include gap arthroplasty, interpositional arthroplasty and total joint reconstruction using alloplastic or autogenous materials [5,6,7,8]. Temporalis myofascial flap is referred as a gold standard in the treatment of TMJ ankylosis in the literature, there have been a number of reports that other autogenous grafts including costochondral graft, dermis fat graft, and skin graft or alloplastic materials were suggested as successful and suitable options. Temproalis myofasica flap is no longer considered the “gold standard” in the management of ankylosis - alloplastic joint replacement is by most specialist TMJ surgeons Another option is the use of human amniotic membrane (HAM) as an interpositional material. Reankylosis and limited range of motion are the most frequently reported complications [3]
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