Lateral Arthroplasty as an Optimal Treatment for Surgical Management of Unilateral Temporomandibular Joint Ankylosis Type III in Children

Abstract

Management of temporomandibular joint (TMJ) ankylosis described in the literature showed many surgical techniques. Purpose: The aim of this study was to evaluate the lateral TMJ arthroplasty as a surgical technique for treatment of type III Sawhney’s TMJ ankylosis in children both clinically and radiographically. In that surgical technique the need of a costochondral graft for reconstructive arthroplasty is avoided with its potential complications (as a donor site) and the unpredictable growth pattern. Materials & Methods: Eight children with unilateral type III Sawheny ankylosis (ankylosis on the lateral aspect of the medially displaced condyle) were included in this research. They all underwent lateral TMJ arthroplasty with the aid of panoramic and coronal C.T views. Evaluation was done both clinically and radiographically regarding interincisal distance, lateral TMJ movement, protrusive movements, postoperative pain, patient’s satisfaction and hazards of facial nerve injury. All patients were seen weekly for 4 weeks, at three and six months then at one year. Results: The used surgical technique of lateral arthroplasty had greatly achieved the desired goals of treating TMJ ankylosis during a follow up period of one year. Those achieved goals include restoration of full mandibular function and free movements of the joint with adequate mouth opening and a mean interincisal distance of 35 mm, maintaining acceptable occlusion and ramus height and obviates the need of any autogenous chondro-osseous graft (commonly costochondral) with potential complications of the donor sites. Conclusion: The surgical procedure of lateral arthroplasty is an easy and safe technique. It is considered as an effective treatment modality in treatment of type III TMJ ankylosis especially in children.