Advertisement

Oral and Maxillofacial Surgery

, Volume 12, Issue 2, pp 61–66 | Cite as

Temporomandibular joint ankylosis: a review of 44 cases

  • Gaurav Jain
  • Sanjeev Kumar
  • Amar S. Rana
  • Vishal Bansal
  • Pankaj Sharma
  • Anne Vikram
Original Article

Abstract

Introduction

Mandibular hypomobility may arise due to a wide variety of intraarticular as well as extraarticular disorders in the temporomandibular joint region. Temporomandibular joint ankylosis causes a variable restriction in jaw mobility. This study presents a broad overview of the management of temporomandibular joint ankylosis at the Department of Oral and Maxillofacial Surgery, GGSM Subharti Dental College, Meerut, Uttar Pradesh, India.

Materials and methods

Between May 2002 and September 2005, a total of 44 patients underwent surgical release of temporomandibular joint ankylosis. This study is a retrospective analysis of the patient population characteristics and the surgical procedures employed.

Results and discussion

The patients have completed a follow-up of 24 to 64 months (median, 38.5 months). Of the 44 patients, 12 had bilateral involvement. Trauma in childhood was, expectedly, the most frequent etiologic factor. Gap arthroplasty was the most frequently employed technique, followed by the use of autologous tissue interposition. The temporalis muscle-fascia and the temporalis fascia alone, as well as the auricular cartilage, were employed most frequently. Complete alloplastic condylar replacement was performed in one patient, who, unfortunately, returned with pain, clicking, and deviation of the jaw, necessitating removal within 1 month. Total joint replacement was abandoned after this case. We outline our protocol for the management of this disabling condition.

Keywords

Temporomandibular joint disorders Temporomandibular joint ankylosis Gap arthroplasty Interpositional arthroplasty 

References

  1. 1.
    Rowe NL (1982) Ankylosis of the temporomandibular joint. J R Coll Surg Edinb 27:67–79PubMedGoogle Scholar
  2. 2.
    Al-Kayat AP, Bramley P (1979) A modified preauricular approach to the temporomandibular joint and malar arch. Br J Oral Surg 17:91–103PubMedCrossRefGoogle Scholar
  3. 3.
    Blair VP (1913) Operative treatment of ankylosis of the mandible. South Surg Gynaecol26436–451(Cited from Kreutziger KL (1984) Surgery of the temporomandibular joint I. Surgical anatomy and surgical incisions. Oral Surg 58:637–646)Google Scholar
  4. 4.
    Alexander RW (1975) Postauricular approach for surgery of the temporomandibular articulation. J Oral Surg 33:346–350PubMedGoogle Scholar
  5. 5.
    Sarma UC, Dave PK (1991)Temporomandibular Joint ankylosis: an Indian experience. Oral Surg Oral Med Oral Pathol 72:660–664PubMedCrossRefGoogle Scholar
  6. 6.
    Roychoudhary A, Prakash H, Trikha A (1999) Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endo 87:166–169CrossRefGoogle Scholar
  7. 7.
    Kaban LB, Perrot DH, Fisher K (1990) A protocol for the management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 48:1145–1191PubMedCrossRefGoogle Scholar
  8. 8.
    Chidzonga MM (1999) Temporomandibular joint ankylosis: review of 32 cases. Br J Oral Maxillofac Surg 37:123–126PubMedCrossRefGoogle Scholar
  9. 9.
    Adekeye EO (1983) Ankylosis of the mandible. J Oral Maxillofac Surg 41:442–449PubMedCrossRefGoogle Scholar
  10. 10.
    Kazanjian VH (1938) Ankylosis of the temporomandibular joint. Surg Gynaecol Obstet 67:333–348Google Scholar
  11. 11.
    Tideman H, Doddridge M (1987) Temporomandibular joint ankylosis. Aust Dent J 32(3):171–177PubMedCrossRefGoogle Scholar
  12. 12.
    Topazian RG (1966) Comparison of gap and interposition arthroplasty in the treatment of TMJ ankylosis. J Oral Maxillofac Surg 24:405Google Scholar
  13. 13.
    Salins PC (2000) New perspectives in the management of craniomandibular ankylosis. Int J Oral Maxillofac Surg 29:337–340PubMedCrossRefGoogle Scholar
  14. 14.
    Long X, Li X, Cheng Y, Yang X, Qin L, QiaoY , Deng M (2005) Preservation of disc for the treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg 63:897–902PubMedCrossRefGoogle Scholar
  15. 15.
    Gunaseelan R (1997) Condylar reconstruction in extensive ankylosis of temporomandibular joint in adults using the resected segment as an autograft: a new technique. Int J Oral Maxillofac Surg 35:157–160CrossRefGoogle Scholar
  16. 16.
    MacIntosh RB (1994) The case for autogenous reconstruction of the adult temporomandibular joint. In: Worthington P, Evans JR Controversies in oral and maxillofacial surgery. WB Saunders, Philadelphia, pp 356–380Google Scholar
  17. 17.
    Figueroa AA, Gans BJ, Pruzansky S (1984) Long term follow up of a mandibular costochondral graft. Oral Surg 58:257–268PubMedCrossRefGoogle Scholar
  18. 18.
    Guyuron G, Lasa CI Jr (1992) Unpredictable growth pattern of a costochondral graft. Plast Reconstr Surg 90:880–886PubMedCrossRefGoogle Scholar
  19. 19.
    Link J, Hoffman DC, Laskin DM (1993) Hyperplasia of a costochondral graft in an adultJ Oral Maxillofac Surg 51:1392–1394PubMedCrossRefGoogle Scholar
  20. 20.
    Saeed NR, Kent JN (2003) A retrospective study of the costochondral graft in TMJ ReconstructionInt J Oral Maxillofac Surg 32:606–609PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Gaurav Jain
    • 1
  • Sanjeev Kumar
    • 1
  • Amar S. Rana
    • 1
  • Vishal Bansal
    • 1
  • Pankaj Sharma
    • 1
  • Anne Vikram
    • 1
  1. 1.Subharti Dental CollegeMeerutIndia

Personalised recommendations