Silicon Interpositional Arthroplasty for Temporo-mandibular Joint Ankylosis.

Abstract

Temporo-mandibular joint (TMJ) ankylosis is characterized by a decreased mouth opening which affects mastication, speech, and facial aesthetic. Interpositional arthroplasty using autologous tissue is accepted treatment for TMJ Ankylosis; however, harvesting autologous tissue is associated with additional morbidity. In this article we report our results of silicon interpositional arthroplasty for TMJ ankylosis. 20 patients with TMJ ankylosis were included in the study. All patients underwent standard operative procedure using preauricular incision for release of TMJ ankylosis by excision of at least 1cm of bony block and insertion of 2cm thick silicon block in the joint space. Postoperatively early mobilization of TMJ was advised from 3rd day onwards. Post operative result was evaluated by assessing the mouth opening as inter incisor distance (IID). 20 patients (27 joints) of TMJ ankylosis were included in the study. There were 8 male and 12 female patients with age ranged from 3-35years. According to Sawhney classification bony ankylosis was present as Type-IV (n = 13 joints), Type-III (n = 12 joints) and Type-II (2 joints). Preoperative mean IID was 7.15mm and post operative mean IID was 43.5. There was no facial nerve paresis, malocclusion or recurrence but infection and extrusion of implant occurred in 1 case each. Silicon interpositional arthroplasty is an effective procedure for the treatment of TMJ Ankylosis; as it restores mouth opening and function, maintains the vertical ramus height, and prevents re-ankylosis without any donor site morbidity.