Recurrent Ankylosis Research Articles

RECURRENT TEMPOROMANDIBULAR JOINT ANKYLOSIS AMONG YEMENIS: A PROSPECTIVE STUDY

Background and aims: Recurrence of ankylosis is one of the most common complication following surgery especially during gap arthroplasty without interposition material. The main aim of these current study was to obtain a comparison between three different methods in prevent of recurrent temporomandibular joint ankylosis. Methods: A number of 15 patients with (2-22 years) age ranged between were obtained from those attending to Al-kawait Hospital, clinic of Oral and Maxillofacial Surgery Department, Sana’a University, Yemen. All patients in the present study that have ankylosis in the temporomandibular joint (TMJ) were included in period time from March 2017 to April 2020. the temporomandibular joint ankylosis Diagnosis was obtained through history of a chief complain, medical history, clinical and radiographic examinations. All patients were divided into three groups based on the type of treatment. Results: No any signs of surgical site infection in or around the incision. In group I: three cases of recurrence ankylosis were happened, while one case was dislodging of cartilage from harvested rib in group II. However, in group III, there were no complications observed after the end period of follow-up. Conclusion: The most effective procedure to prevent recurrence of temporomandibular joint ankylosis was the temporalis fascia as interpositional material, also produce a good esthetic and function results. Peer Review History: Received: 25 December 2022; Revised: 8 February; Accepted: 5 March 2023, Available online: 15 March 2023 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Similar Articles: HISTOLOGIC AND RADIOGRAPHIC STUDY OF PATHOLOGIC CHANGE IN COMPLETE IMPACTED THIRD MOLARS DENTAL FOLLICLES

Temporomandibular joint reankylosis: A case report

Ankylosis of the temporomandibular joint (TMJ) occurs when the base of the skull fuses with condyle to the mandible. This can cause deleterious effects on the growth and development of the jaws and teeth when occurred in childhood. Recurrence of TMJ ankylosis is a known complication. Studies have contributed to the various treatment options in recurrent ankylosis. The causes of reankylosis of TMJ are due to inadequate gap arthroplasty, insufficient interpositional material, adhesion, and elongation of the coronoid process. This case report is about a 6-year-old female child who is not able to open the mouth. The child was diagnosed with TMJ reankylosis. The treatment consisted of gap arthroplasty with dermis-fat graft along with bilateral coronoidectomy followed by vigorous physiotherapy. Later, full-mouth rehabilitation with speech and functional therapy and psychological counseling was done. Treating TMJ ankylosis is challenging as it has technical difficulties and a high incidence of recurrence. Hence, the treatment is always a multidisciplinary approach inclusive of an oral and maxillofacial surgeon, a pediatric dentist, and a psychologist and a physical therapist.

Abdominal Dermis-Fat Graft Versus Conventional Temporalis Myofascial Flap Interposition in Temporomandibular Joint Ankylosis: A Prospective Clinical Comparative Study.

Temporomandibular joint (TMJ) ankylosis is an extremely disabling condition with almost complete inability to open the jaws causing difficulty in chewing, speech, poor oral hygiene and cosmetic disfigurement. Temporalis myofascial flap still remains the most common interpositional material used; however, patients usually complain of pain during movement, unesthetic bulging in the temporal region and trismus due to scar contracture. The main aim of the study was to evaluate the efficacy of abdominal dermis-fat graft and compare it with temporalis myofascial flap as to see which of the two grafts offers more advantages and provides better postoperative results following TMJ ankylosis surgery. A total of 30 diagnosed cases of TMJ ankylosis were randomly divided into two groups of 15 patients each. All the patients underwent TMJ ankylosis release under general anesthesia followed by abdominal dermis-fat interposition in Group A and temporalis muscle in Group B. The patients were assessed for pre-operative and postoperative mouth opening (immediate and 6month postoperative), pain during physiotherapy, donor and surgical site complications and recurrence of ankylosis. The mean maximum inter-incisal opening in dermis-fat group was significantly higher than temporalis group both at immediate and 6month postoperative periods (p = 0.041, 0.001). Physiotherapy was less painful in dermis-fat group than in temporalis group, and the differences in VAS scores among the 2 groups showed high statistical significance (p < 0.001). Hypertrophic scar developed at the donor site in 2 patients in dermis-fat group; however, it was located below the beltline and hardly noticeable. A total of 9 patients (4 in Group A and 5 in Group B) developed temporary facial nerve weakness, and no case of re-ankylosis was noted in either group. Dermis-fat graft in temporomandibular joint ankylosis showed better results than conventional temporalis myofascial flap in terms of postoperative mouth opening, physiotherapy and jaw function with esthetically acceptable results.

Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

BackgroundsThe purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses.Case presentationA 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication.ConclusionFor a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

Simultaneous arthroplasty and distraction osteogenesis for the treatment of ankylosis of the temporomandibular joint and secondary mandibular deformities in children

The purpose of this study was to explore the use of simultaneous arthroplasty and distraction osteogenesis in the treatment of children with ankylosis of the temporomandibular joint (TMJ) and secondary mandibular deformities. Between January 2012 and December 2016, 17 children (7 boys and 10 girls, mean (range) age 7 (4–12) years) were treated. Preoperatively, the mean (range) maximal incisal opening was 1.4 (0–5) mm. Distraction osteogenesis was used to elongate the mandibular body or ramus, or both, after the release of ankylosis. Distraction began after five to seven days at a rate of 0.5mm twice daily, and the distractor was removed three to five months after the completion of distraction. The mean (range) follow-up time after removal was 29.6 (16–45) months, and the distance of distraction was 14.4 (10–18) mm. After treatment, all patients had satisfactory outcomes, a good facial profile, alignment of the midline lower incisor, and a level occlusal plane. The mean (range) maximum incisal opening reached 35.7 (31–41) mm. Bone formation across the distraction gap was good. The mean minimum axial area of the airway increased from 61.4mm to 96.4mm (p<0.01). No patients had a recurrence of ankylosis during follow up. Our results suggest that simultaneous arthroplasty and distraction osteogenesis is feasible in this group.

Clinical outcome of total alloplastic temporomandibular joint reconstruction in cases of recurrent ankylosis with emphasis on pitfalls: A retrospective analysis

AimThe present study is designed to evaluate the pitfalls and complications in treatment of recurrent TM Joint Ankylosis cases using total alloplastic joint replacement. Materials and methodsData was analyzed retrospectively in terms of maximum mouth opening, deviation during opening of mouth, heterotrophic bone formation, peri-joint infection, and intraoral exposure of joint, post-surgery malocclusion, contralateral TMJ pain. Results12 patients (15 joints) of TMJ ankylosis were treated with TMJ replacement in our department. Mean pre-operative maximum inter-incisal mouth opening was 3.92 mm (SD ± 1.73). Post op mean inter-incisal opening three month, six month and one year were 31.59 mm, (SD ± 3.15) 32.25 mm(SD ± 1.82), 32.67 mm (SD ± 2.19)respectively. There were 2 cases of malocclusion, 1 case of infection and 1 case of intra-oral exposure of joint. ConclusionThe success rate available in literature for use of alloplastic joint replacement in treatment of end stage TMJ disorders which includes a large area of different types of temporomandibular joint disorders cannot be implicated. In our study we found complication free success rate of 67%. A large study focusing specifically on use of alloplastic joints in recurrent ankylosis cases is needed for the subcontinent.

Does Surgical Release of TMJ Bony Ankylosis Increase the Risk of Trigeminocardiac Reflex? A Retrospective Cohort Study

The exact frequency of the trigeminocardiac (TGC) reflex in temporomandibular joint (TMJ) surgery is still controversial. The purpose of the present report was to estimate the frequency of and identify the risk factors for TGC reflex among patients undergoing operative management of TMJ ankyloses. A retrospective cohort study was conducted of patients who had undergone gap arthroplasty for TMJ ankyloses at Al-Azhar University Hospital, Cairo, Egypt, from 2001 to 2015. The predictor variables were patient demographic data (age and sex), ankylosis type, and surgery type. The outcome variable was the occurrence of the TGC reflex (yes vs no). The data analysis included descriptive statistics and χ2 tests to compare the categorical variables. Binary regression logistic model analysis was performed to identify the associated predictor variable. P values were considered statistically significant at ≤ .05. The sample included 55 subjects. The mean±standard deviation age of the patients was 21.3±9.855years, and 43.6% were males. The frequency of TGC reflex was 12.7%. The factors associated with an increased risk of TGC reflex were type IV bony ankylosis (P=.012) and the need for repeat surgery (P=.016.). A multivariable binary regression model analysis demonstrated that the recurrence of surgery was the most significant predictor factor affecting the frequency of the TGC reflex. The computed variance ranged from 13 to 25%. However, other variables, including age, gender, side, and ankylosis type, were not associated with reflex onset (odds ratio, 0.028; 95% confidence interval, 0.001 to 0.911; P=.044). Recurrent ankylosis surgery carries a high risk of TGC reflex. Preoperative risk factor identification and close monitoring are crucial to prevent the occurrence of this reflex in susceptible patients. Future research projects should include more variables in the study.

Treatment of temporomandibular joint ankylosis with severe mandibular deficiency by Biomet temporomandibular joint prosthesis

Background: Temporomandibular joint (TMJ) ankylosis is a refractory disease that is easy to recurrent. Objectives: This study aimed to evaluate the effects of TMJ prostheses in the treatment of TMJ ankylosis in patients with severe mandibular deficiency. Methods: Patients treated from 2013 to 2015 were reviewed. The computer-aided design/computer-aided manufacturing technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Their facial profile, mouth opening and the results of computed tomography examination were evaluated. Findings: 11 patients with 15 joints were included. In four patients with severe mandibular deficiencies, their mandibular ramus was elongated by TMJ prostheses combined with Le Fort I osteotomy guided by digital templates. Their mean chin advancement was 10.19 mm. Their SNB and ramus heights were also significantly improved after operation (P < 0.05). All prostheses were successfully installed and stabilised intraoperatively. There was no prosthesis loosening, breakage, or infection leading to removal. No ectopic bone formations were found around the artificial condyles, and no bone resorption was detected around the screws after a mean follow-up period of 21 months (8–31 months). Mouth opening was significantly improved from 5.5 mm preoperatively to 31.6 mm postoperatively. Conclusion: TMJ prosthesis is a reliable treatment method for ankylosis, especially recurrent ankylosis. It can correct jaw bone deformities simultaneously with stable results.

Managing the complexities of obstructive sleep apnoea syndrome, reankylosis and poor aesthetics in temporomandibular joint ankylosis — an experience of 18 years in the Indian population

Background: Temporomandibular joint (TMJ) ankylosis is a complex disorder, the problems associated with it can be multiple e.g. difficulties in mastication, speech, poor nutrition, poor oral hygiene, malocclusion, compromised airway, poor aesthetics and recurrence. All of these invariably result in the physical and psychological disability of the patient. Management of TMJ ankylosis is challenging, being associated with intraoperative risks, rehabilitation difficulties and chances of recurrence. Though its treatment has been discussed in the literature for over 200 years, no single technique has produced long-term successful outcomes. In a clear understanding TMJ ankylosis is not a neoplastic disease yet recurrence rates as high as 25% are reported in long-term studies. Objectives:1.To introduce new reforms and modifications in the existing surgical procedures for prevention of reankylosis.2.To discuss the timing and importance of distraction for obstructive sleep apnoea (OSA) to prevent reankylosis and its role in rehabilitation with or without genioplasty.3.To highlight the role of dermis fat as an interpositional material.4.To introduce a system of classification for recurrent ankylosis for planning the treatment modality.5.To scrutinise reasons for reankylosis with old protocols and report the success of new protocols that were used to suit the Indian population for the economically backward population. Methods: A retrospective statistical analysis and scrutiny of a total of 125 patients of ankylosis over 18 years who received treatment with old (33 cases) and new protocols (48 cases) and further revised protocol (23 cases) with recent new reforms was carried out. Conclusions: Based on our clinical experience with the introduction of new reforms and the adaptation of modified protocols we were able to achieve a drastic reduction in the recurrence rates from 18.1 to 5.8% to nil, besides minimising the postoperative adverse sequel, correcting OSA and improving aesthetics with distraction osteogenesis.

Recurrence of temporomandibular joint ankylosis: Fascia lata a good alternative. A case report

Recurrence of temporomandibular joint (TMJ) ankylosis is a known complication. Studies have contributed to the various treatment options in recurrent ankylosis. The causes of reankylosis of TMJ, to our experience is due to inadequate gap arthroplasty, insufficient interpositional material, adhesion and elongation of the coronoid process. It has been reported in the literature that the incidence varies with choice of treatment modality, severity of ankylosis, site (unilateral/bilateral), and the surgeons skill. The patient's compliance to the post-treatment physiotherapy is the main reason for reankylosis. Here, we present a case of left TMJ reankylosis in a 22-year-old female, previously treated by interpositional gap arthroplasty using temporalis muscle, and had developed recurrence after ˜ 1 year of treatment, then it was successfully treated with gap arthroplasty using fascia lata as interpositional material.

Fate of Free Fat Dermis Graft in TMJ Interpositional Gap Arthroplasty: A Long Term MRI Study.

Free fat dermis graft is a good interpositional material for TMJ gap arthroplasty. Analysing the fate of the graft by magnetic resonance imaging (MRI) images helps in excellent visualization of both bony and soft tissue anatomy of the operated TMJ joint as well as in assessing the changes in dermis graft which was previously placed. To investigate the radiological fate of the dermis-fat graft within the TMJ using MRI. Five joints of five patients who had dermis-fat grafts placed in their TMJ following gap arthroplasty were recruited for this study. Each patient had undergone TMJ gap arthroplasty with immediate dermis-fat graft placement. All the patients are then subjected to MRI. Fat graft was identified in close proximity to the mandibular condyle in all cases, with only three joints demonstrating fat covering the entire articular surface of the mandibular condyle. In the remaining joints the interpositional material found in the MRI defined joint space with mainly grey appearance, suggesting tissue change to other than fat, i.e. scar or granulation tissue. When free fat dermis graft is placed as interpositional material the graft occupied the entire TM joint and prevented it from recurrent ankylosis. The graft placed aids in normal functioning of the temperomandibular joint without any complications.

Management of temporomandibular joint ankylosis type III: lateral arthroplasty as a treatment of choice

Many surgical techniques for the management of temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this study was to report our experience using a lateral arthroplasty technique in the management of type III ankylosis. The records of 15 patients treated for TMJ ankylosis at our institution between 2007 and 2011 were reviewed. Pre- and postoperative information collected included age, gender, aetiology, ankylosis type/classification, existing facial asymmetry, maximum pre- and postoperative mouth opening, complications, and recurrence of ankylosis. The mean maximum inter-incisal opening in the preoperative period was 12.9mm and in the postoperative period was 36.2mm. No major complication was observed in any patient. No recurrence was noted in any patient. Our working hypothesis was that for patients with ankylosis type III, the medially displaced condyle and disc can fulfil their role in mandibular function and growth after extirpation of the ankylozed mass. Although they are located in an awkward medial position, they should function exactly as they would after a properly treated, displaced condylar fracture.

Total Alloplastic Temporomandibular Joint Reconstruction for Management of TMJ Ankylosis.

Temporomandibular joint (TMJ) ankylosis involves the fusion of the mandibular condyle to the glenoid fossa, the skull base. The dilemma with regards to treatment planning whether distraction is done before gap arthroplasty or as a simultaneous procedure or after gap arthroplasty is still a controversy. In an attempt to carry out both the procedures simultaneously there is loss of vector control of the distal segment and the risk of pseudoarthrosis at the osteotomy site. This combined problem could be overcome by the use of total alloplastic joint prosthesis which offers a firm posterior stop for the proximal segment and negates aggressive physiotherapy. The reference literatures were retrieved from Pub Med and Science Direct database. Three case reports of bilateral recurrent TMJ ankylosis successfully treated with custom made total TMJ by the authors are illustrated. The purpose of this article is to review the world literature on various alloplastic joints available for TMJ reconstruction and to introduce our indigenous total joint prosthesis in the management of recurrent ankylosis.

Die Transposition des Musculus biceps femoris zum Ersatz des Kniegelenkstreckers nach Resektion des Musculus quadriceps

Improvement of gait and ability to stand by reconstruction of functional knee extension. Loss of function of the quadriceps femoris muscle due to tumour resection or traumatic damage of the muscle with loss of active knee extension. Inadequate strength of the biceps femoris muscle. Recurrent tumour or ankylosis of the knee joint. The tendon of the biceps femoris is dissected near the knee at the head of the fibula and is mobilized proximally. The underlying common peroneal nerve and the neurovascular supply of the biceps muscle must be spared. Through a ventral approach at the thigh the lateral intermuscular septum is opened and the biceps tendon is pulled through and sutured to the quadriceps tendon and periost of the patella. The knee is immobilized in extension with a cast followed by a knee orthosis for 6weeks, which is followed by intensive physiotherapy; however, the patient should not be forced to flex the knee extensively. The orthosis can be worn for another 3-4weeks to stabilize the knee joint, while the muscles are intensively trained. Reliable reconstruction of functionally useful, active knee extension without an orthosis of a previously unstable knee joint in the sagittal plane, even if full extension is not to be expected.

Biological Reconstruction of the Temporomandibular Joint by Chondro-Osseous Graft

This study includes 35 children treated by reconstruction of the temporomandibular joint (TMJ) by chondro-osseous graft harvested from iliac crest for management of 2 diseases; the first one was ankylosis of the TMJ. There were 25 cases of 9 girls and 16 boys, and there were 10 cases of hypoplasia of the TMJ of first-arch dysplasia syndrome or hemifacial microsomia, of which 4 were females and 6 were males. Their ages ranged between 4 and 13 years (mean, 8.5 years); follow-up of the patients ranged from 3 to 5 years. All patients showed good result and without recurrence of ankylosis or restriction of mouth opening, and growth of the face was acceptable and without using osteotomies for correction of jaw relationship or distraction techniques.Experimental studies on rabbits were performed to prove the condyle as growth center and after excision of the head of condyle and disk in newly growing rabbits of 3 months of age; after 3 months of follow-up, we observed severe deformity of the rabbits' mandible, and the mandible deviated to the affected side on the first experiment. In the second experiment, reconstruction of the TMJ and condyle of the rabbits by chondro-osseous graft harvested from iliac crest of the same rabbit was carried out in 8 animals to assess the viability and value of chondro-osseous graft to replace the TMJ. After 3 months, all animals were killed. Postmortem studies were done to assess the healing process of the graft or any resorption of the graft. Histological studies of the graft showed 4 layers: the first articular layer was thick because of functional demand of masticatory process for hard food of rabbits; the second layer was the granular mesenchymal stem cells layer, very active and multiple layers that represent the proliferative layer; the third layer showed conversion of cartilage cells to osteoid cells, and the fourth layer was the osteoid layer. On follow-up of clinical cases, the graft was continued for functional demand of growth, repair, and remodeling of the condyle.

Two-Stage Total Prosthetic Reconstruction of Temporomandibular Joint in Severe and Recurrent Ankylosis

Temporomandibular joint ankylosis is a devastating condition for the patient associated with both functional disability and aesthetic deformities. Various techniques have been described in the literature to overcome this problem; however, there is still a high risk of reankylosis in patients undergoing multiple temporomandibular joint operations, severe heterotopic ossification, and fibrosis of the soft tissues. This study includes 5 patients with severe and recurrent ankylosis. Two-stage reconstruction with excision of the bony mass and placement of a distraction device in the first stage, followed by gradual distraction of soft tissues, and placement of a total joint prosthesis in the second stage were performed in all patients. The 2-step approach helps to overcome the fibrosis and adhesions in the soft tissues and allows placing an implant with a higher ramus component. This approach seems to be a useful and effective technique for the management of such patients with high risk of reankylosis.

Management of recurrent ankylosis in arthrogryposis: new solutions to a rare problem

Arthrogryposis is a rare condition that comprises contracture of the joints, muscular weakness, and fibrosis. Restricted mouth opening caused by coronoid hyperplasia has been reported but to our knowledge, ankylosis of the temporomandibular joint (TMJ) has not. Standard management of ankylosis includes creation of a gap arthroplasty and possible reconstruction with autogenous or alloplastic materials. We describe management of a patient with arthrogryposis who developed ankylosis for a second time after satisfactory gap arthroplasty and total replacement of the TMJ with a custom-made prosthesis. The original prosthesis was removed, the ankylosis resected, and the prosthesis replaced. This has given an excellent outcome at 12 months.

Management of Temporomandibular Joint Ankylosis Associated With Mandibular Asymmetry in Infancy

Temporomandibular joint (TMJ) ankylosis during early childhood always produces alteration of the mandibular growth with facial asymmetry, chin deviation, and malocclusion. The younger the ankylosis happens, the more severe the facial deformity presents. When TMJ ankylosis occurs in infancy, there might be a delay in diagnosis and treatment. In this article, we describe a case of TMJ ankylosis in a 10-month-old boy. The etiology was indistinct. Surgical plan including modified gap arthroplasty, costochondral graft (CCG), temporalis fascial flap, was preformed to this patient. The joint and the mandibular ramus were restored. No severe complication occurred. There was no recurrence of ankylosis and further developing of mandibular asymmetry during 2-year follow-up period.

Intraoral approach for arthroplasty for correction of TMJ ankylosis

This study evaluates the authors' technique using the intraoral approach for the management of temporomandibular joint (TMJ) ankylosis. The technique was used on 16 TMJs in 14 patients with a mean age of 28.5 years; their average postoperative mouth-opening was 33.7 mm. All the patients had Sawhney's type IV TMJ ankylosis except a child with type I. One patient had recurrent ankylosis and was managed using the same intraoral approach again. Average follow-up was 56 months. The protocol consists of interpositional arthroplasty via an intraoral approach and aggressive mouth-opening exercises. An intraoral incision is made over the buccal shelf and the soft tissue of the mandibular ramus reflected. Osteotomy is carried out at the coronoid process and adequate osteotomy is accomplished at the level of the condylar neck. Adequate gap osteotomy at the ankylosed condyle is performed and followed by placement of the interpositional material, such as rib cartilage, masseter, buccal fat pad and costochondral graft. The wound is then closed meticulously. The advantages of this intraoral approach are excellent cosmetic appearance with no facial scar, lower risk of injury to the facial nerve or auriculotemporal nerve and no salivary fistula formation.

Transport distraction versus costochondral graft for reconstruction of temporomandibular joint ankylosis: which is better?

This study compared the methods of transport distraction and costochondral graft in reconstruction of temporomandibular joint (TMJ) ankylosis. Bilateral bony TMJ ankylosis was induced in 12 adult goats. Transport distraction of the mandibular ramus was performed on one side, whereas costochondral graft was performed on the other side. Jaw movements, TMJ healing, condylar remodeling, and recurrence of ankylosis were assessed by clinical, radiological, and histological examinations. Both transport distraction and costochondral graft established a neo-condyle separating from the pseudo-disc with a joint space. The ankylosis scores were higher in the distraction side in the first 12 weeks. Both techniques showed no significant difference in the calcification scores and recurrence of ankylosis in the long term. The maximal jaw movements in 3 directions returned to the pre-ankylosis stage by both methods. Distraction osteogenesis is an effective reconstruction method for TMJ ankylosis, matching the gold standard of costochondral grafting.