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Surgical treatment of temporomandibular joint ankylosis: Skims experience of 105 cases

Authors: Shakeel M., Imran M., Ahad B., Shafi M. and Khan A

Int J Med Res Health Sci.77-82 | pdf PDF Full Text

Ankylosis is a very common condition developed mainly after damage to mandibular condyles or
temporomandibular joint (TMJ) at a growing age.Treatment of temporomandibular joint ankylosis is a challenge
and suffers from a high incidence of recurrence. Although treatment of ankylosis has been tried as early as nearly
200 years ago, no single technique produced satisfactory results. To report our experience of 105TMJ ankyloses
cases managed with different surgical modalities from 1999 to 2014 in our institute. The sample consists of all the
patients who have been operated in our deptt. fortmj ankyloses using different surgical treatments from 1999 to
2014. Pre- and postoperative assessment included a thorough history and physical examination to determine the
cause of ankylosis, the maximalincisal opening, type of the ankyloses and recurrence rate. The mean age was
15.4,12.4,13.6 and 14.3 years for gap arthoplasty, interpositional arthroplasty with CCG, Interpositional
arthroplasty with acrylic spacer and Interpositional arthroplasty with temporalis myofacial flap respectively.
Trauma was the only etiological factor in all the cases of the present study. Preoperative CTscans revealed various
types of ankylosis, according to Sawhney’s classification (9), type I (n=21), type II (n=40), type III (n=49) and type
IV (n=8). The mean maximal incisal opening (MIO) in the pre and post operative period was 10.2 and 38.3 in gap
arthroplasty group,10.5 and 34.3 in interpositional arthroplasty with CCG group,15.3 and 28.7 in interpositional
arthroplasty with acrylic spacer group and 7.1 and 38.4 in interpositional arthroplasty with temporalis myofacial
flap group. The recurrence rate was 10% (n=3) in gap arthroplasty,2.63% in interpositional arthroplasty with CCG
group,8.33% in interpositional arthroplasy with acrylic spacer group and no recurrence was observed in
interpositional arthroplasy with temporalis myofacial flap group. The recurrence always occurred in ankylosis type
IV in all groups.

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