scholarly journals Multidisciplinary management of temporomandibular joint ankylosis in an adult: journey from arthroplasty to oral rehabilitation

2021 ◽  
Vol 14 (9) ◽  
pp. e245120
Author(s):  
Kamlesh Kothari ◽  
Naveenkumar Jayakumar ◽  
Aayesha Razzaque

Ankylosis of the temporomandibular joint is a debilitating condition resulting in progressive trismus and facial disfigurement. Common trigger factors include paediatric mandibular trauma, middle ear infection or traumatic childbirth. Although diminishing in incidence among urban population, it is still prevalent in the underprivileged world. Substandard child safety norms, delayed presentation, lack of access to specialties like maxillofacial surgery in rural areas and absence of follow-up contribute to ankylosis. Afflictions in ankylosis are multipronged, involving aesthetic, functional, psychological and nutritional implications to name a few. The damage this pathology causes to the young mind and their morale is humongous. Although well documented, a complete presentation of cases with follow-up till oral and myofascial rehabilitation is seldom reported. This paper describes multidisciplinary management of a young female patient with temporomandibular joint ankylosis. Staged management commencing from interpositional arthroplasty until dental restoration with a 2-year follow-up is presented in this paper.

2005 ◽  
Vol 42 (6) ◽  
pp. 694-698 ◽  
Author(s):  
Vera Lúcia Gil-da-Silva-Lopes ◽  
Daniela Varela Luquetti

The objective of this study was to describe four unrelated patients affected by congenital temporomandibular joint ankylosis. Clinical delineation, natural history, and possible etiologies are discussed. Clinical aspects that are important for follow-up are outlined.


2013 ◽  
Vol 2 (4) ◽  
pp. 183-186
Author(s):  
Mehdi Sezavar ◽  
Zahra Malekpour ◽  
Maryam Sohrabi ◽  
Mojtaba Salehi

Background: Different interpositional materials have been used to prevent recurrence after gap arthroplasty in temporomandibular joint ankylosis. In this study, the temporalis superficial fascia flap was evaluated as an interpositional material after condylectomy. Materials and Methods: 9 Cases of unilateral or bilateral temporomandibular joint ankylosis were evaluated in this study with a follow-up of 12 months. The Al-khayat approach was used as the surgical technique with the inferiorly based temporalis superficial fascia flap. Results: 9 Patients (6 female and 3 male) had a preoperative maximal inter-incisal opening of 3 to 10 mm. During the last follow-up observation after surgery, patients had a maximum inter-incisal opening of 40 to 45 mm. Paresthesia or anesthesia of the temporal branch of facial nerve was absent in all cases. There were no signs of re-ankylosing in any of the patients. Conclusion: The findings of this study showed that the temporalis superficial fascia flap is a good alternative as an interpositional material in treatment of temporomandibular joint ankylosis.


2014 ◽  
Vol 29 (2) ◽  
pp. 28-31
Author(s):  
Ferdinand Z. Guintu ◽  
Alexander T. Laoag ◽  
Joselito F. David

Objective: To present a case of bilateral temporomandibular joint ankylosis that was managed successfully through gap arthroplasty. Methods: Design:   Case report Setting:   Tertiary Government Hospital Patient:   One Results: A 25-year-old man presented with inability to open his mouth for 18 years after direct trauma to his chin.  CT scan showed bilateral bony fusion of condyles to glenoid fossae, hypertrophic sclerosis and fusion of the condylar heads to the temporal bones. He underwent bilateral gap arthroplasty via preauricular approach with creation of a 15 mm space on the mandibular fossa. As of latest follow up, the patient maintained an inter-alveolar distance of 30 mm for 5 months postoperatively, through continuous aggressive mouth opening exercises. Conclusion:      Gap arthroplasty may be an efficient procedure for temporomandibular joint ankylosis in achieving satisfactory post-operative inter-alveolar opening and articular function. Early and meticulous rehabilitation is required to prevent relapse. Long-term follow up is recommended to document possible recurrence.   Keywords: temporomandibular joint ankylosis, gap arthroplasty, TMJ ankylosis, ankylosis


2009 ◽  
Vol 42 (02) ◽  
pp. 182-187
Author(s):  
Satyaswarup Tripathy ◽  
Mohd Yaseen ◽  
Nitya N. Singh ◽  
L. M. Bariar

ABSTRACTTemporomandibular joint ankylosis which is most frequently caused by trauma, presents with restriction in mouth opening in early stages and if children are the victim and not treated early, it presents with growth retardation of the involved mandibular side. Various methods are available for surgical correction. We have reviewed our experience with the efficacy of different interpositional materials in post-traumatic cases in our set up with special reference to temporal fascia over last three years. Twenty seven patients with history of trauma, mostly fall from height, have been studied. They were evaluated clinically and by computed tomography (CT) scan, orthopantogram and x- ray lateral oblique view. The most common age group was 10-15 years with mean 12.5 years and male to female ratio 1:2. Preoperative mouth opening (inter incisor distance) was 1-2 mm in 17 cases and 2-4 mm in 10 cases. We have used temporalis fascia in nine, costochondral graft in seven, silastic sheets in five and T-plates in six cases. Post-operatively, adequate mouth opening of 30-50 mm was observed in six months follow-up and more than 50 mm at one year follow up in 21 cases out of which nine cases have interpositional material as temporalis fascia alone. The postoperative period was uneventful in all cases and none required re-operation for recurrences. We conclude that interpositional arthroplasty, especially with pedicled temporal fascia, is the best method to prevent recurrences and establish good mouth opening and full range of jaw movements.


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