Ankylosis of the Temporomandibular Joint (TMJ) Update and its treatment

In dentistry, temporomandibular joint (TMJ) ankylosis is a rare pathology where no consensus of global population data has been found and therefore has presented a challenge for professionals, since there are no treatment sequence protocols standardized. The objective is to carry out a literature review and update of the diagnosis of ankylosis, considering its clinical characteristics, classification, etiology, and epidemiology. Giving special emphasis to the types of treatments used and concluding that GAP interpositional arthroplasty and TMJ reconstruction arthroplasty would be the best options to improve maximum oral opening in a patient with ankylosis, thus allowing him to recover function and aesthetics.

Low-cost procedure for deformity correction in rheumatoid hands

Background Surgical correction of ulnar drift of metacarpo-phalangeal joint (MPJ) due to Rheumatoid arthritis (RA) is conventionally done by silicon joint arthroplasty which is expensive and may be associated with many complications. We report the outcome of low-cost autologous interpositional arthroplasty. Material and methods Five patients (8 hands, 32 arthroplasties) underwent correction of ulnar drift of MPJ by dorsal capsule interpositional arthroplasty. Results were assessed according to the degree of recovery of movement at the MPJ and correction of ulnar drift. Functional improvement was graded as excellent, good and fair. Pain alleviation was assessed by visual analogue score (VAS) score. Results Excellent results were seen in 3 patients (5 hands, 20 arthroplasties), good in 1 patient (2 hands, 8 arthroplasties) and fair in 1 patient (1 hand, 4 arthroplasties). VAS score for pain decreased from mean preoperative 8.2/10 to 1/10. On average follow up of 1.4 years there was good hand function, no recurrence of deformities and patients were pain free. Conclusion Interpositional arthroplasty for MPJ using dorsal capsule for correction of post RA ulnar drift is a low-cost option which improves the hand function and cosmesis. Additionally, it avoids all the complications related with the use of silicon joints.