Development and validation of temporomandibular joint ankylosis quality of life questionnaire

The patient-reported outcome measures are endorsed for better evaluation of disease impact and treatment outcomes. Temporomandibular joint (TMJ) ankylosis has been observed to adversely impact the quality of life (QoL) of the patients, affecting both the physical and psychosocial aspects of their lives. The study was conducted to develop and validate a TMJ ankylosis specific QoL questionnaire (TMJAQoL). It had two phases. Phase 1 was associated with the development of the questionnaire while phase 2 examined its psychometric properties and validated the instrument. In phase 1, a 65 item pool was generated and was eventually reduced to a 37 item pool after sequential evaluation by two expert groups. The 37 item draft was subjected to item reduction by the impact method, resulting in a 12 item draft divided into 4 domains, which formed the TMJAQoL questionnaire. In phase 2, the TMJAQoL was completed by 51 TMJ ankylosis patients and was found to have optimum validity, reliability and internal consistency. 44 of these patients completed the TMJAQoL again after the surgery. A significant change in mean cumulative TMJAQoL scores (pre-op = 14.10, post op = 4.05, p = .001) was found after the surgery. This change was significantly correlated to the improvement in the maximal incisal opening and the right and left lateral movements (r > .30). Amongst the TMJAQoL domains, significant improvement was seen in functional limitation (p = .026), psychological well being (p = .017) and social wellbeing domains (p = .038). Overall, improved QoL was observed after the TMJ surgery. The TMJAQoL demonstrated optimum psychometric properties and promises to be an effective QoL instrument for the TMJ ankylosis patients.     

Quality of Life in orthognathic surgery patients: Post-surgical improvements in aesthetics and self-confidence

The objective of this prospective study was to assess changes of Quality of Life (QoL) in patients undergoing bimaxillary orthognathic surgery. Questionnaires were based on the Oral Health Impact Profile (OHIP, items OH-1–OH-14) and three additional questions (items AD-1–3), and were completed by patients (n = 50; mean age 26.9 ± 9.9 years) on average 9.1 ± 2.4 months before surgery, and 12.1 ± 1.4 months after surgery, using a scoring scale. Item scores describing functional limitation, physical pain, physical disability and chewing function did not change significantly, whereas item scores covering psychological discomfort and social disability domains revealed significant decreases following surgery. AD-2 “dissatisfying aesthetics” revealed the greatest difference between pre- and post-surgical scores (p < 0.001). If there was a perception of aesthetic improvement of facial features post-surgery, the benefit in QoL was generally high. The significant correlation of the pre- to post-surgical changes of item OH-5 “self conscious” to nearly all other item changes suggested that OH-5 was the most sensitive indicator for post-surgical improvement of QoL. Psychological factors and aesthetics exerted a strong influence on the patients’ QoL, and determined major changes more than functional aspects did.     

Effect of submental flap reconstruction versus obturator rehabilitation after maxillectomy on quality of life: a randomized clinical trial

The surgical removal of a maxillary tumour will result in an oronasal communication, which can negatively affect the patient’s life and daily functions. Following maxillectomy, the defect can be treated with a prosthetic obturator or microvascular flap. However, the gold standard technique remains controversial. The aim of this study was to evaluate and compare quality of life (QoL) outcomes of submental island flap versus maxillary obturator reconstruction after partial maxillectomy. Sixty patients indicated for maxillectomy were allocated randomly to two equal-sized groups. Control group patients underwent reconstruction with a surgical obturator, while intervention group patients underwent submental island flap reconstruction. Patient QoL was evaluated at the 6-month follow-up using the University of Washington Quality of Life Questionnaire. Statistically significant differences in QoL were found between the two groups. Chewing (P = 0.034), swallowing (P < 0.001), speech (P = 0.009), taste (P = 0.04), mood (P = 0.01), and anxiety (P = 0.003) domains showed a statistically significant improvement in the submental group compared to the obturator group. However, the obturator group showed a greater improvement in appearance (P < 0.001). The masticatory function scores in the obturator group were significantly higher after obturator rehabilitation (P < 0.001). In conclusion, this study found that submental flap reconstruction provided better function and QoL than the obturator. This reconstruction was associated with less pain and better pronouncing of words, chewing, swallowing food, and psychosocial adjustment.     

Health-related quality of life of patients treated with primary chemoradiotherapy for oral cavity squamous cell carcinoma: a comparison with surgery

Our aim was to document the health-related quality of life (QoL) of patients with squamous cell carcinoma (SCC) of the oral cavity who were treated with chemoradiotherapy, and to compare it with that of patients treated with conventional surgery with or without adjuvant treatment. All patients who presented with SCC of the oral cavity treated with chemoradiotherapy alone at the Royal Brisbane & Women's Hospital between 2000 and 2011 and who were alive without disease were included. Health-related QoL was assessed by the University of Washington QoL questionnaire version 4, and the European Organisation for the Research and Treatment of Cancer (EORTC) QoL questionnaires C30 and HN35. The questionnaires were sent to all survivors. Those who responded to chemoradiotherapy were matched with patients who were treated by conventional surgery with or without adjuvant treatment by age, sex, subsite of tumour, and TNM stage. Sixteen patients completed the questionnaires (8 in each group). There was no significant difference between the 2 groups in any of the domains of any of the questionnaires. The overall outcome scores for both treatments in all 3 groups were reasonably high, which suggests that both treatments provided acceptable health-related QoL. The surgical group recorded higher scores than the chemoradiotherapy alone group in all domains of the UW-QoL except shoulder and anxiety. They recorded lower scores in all scales and items of EORTC HN35. There was no significant difference in health-related QoL between the 2 groups. Conventional surgery with or without adjuvant treatment recorded higher scores in most QoL domains including chewing, swallowing, saliva, and speech, issues most important to patients with SCC of the oral cavity.     

Impact of prolotherapy in temporomandibular joint disorder: a quality of life assessment

Chronic pain and functional impairment associated with temporomandibular joint (TMJ) disorders (TMD) considerably reduce oral health-related quality of life (OHRQoL). In the present study we have assessed the influence of prolotherapy in patients with TMD by the subjective measurement of QoL using the Oral Health Impact Profile-14 (OHIP-14). Twenty-five patients diagnosed with TMD (mean (range) age 38 (18 – 70) years) were included. They had all undergone dextrose prolotherapy to the TMJ at regular time intervals (four times at intervals of two weeks) using the method suggested by Hemwall-Hackett. They were asked to answer the OHIP-14 questionnaire before and two years after prolotherapy. Seven domains of OHRQoL were rated on a 5-point Likert scale from 0 (never) to 4 (very often). Domain scores and total OHIP-14 scores were compared using inferential statistics (chi squared and Wilcoxon signed rank tests). Prolotherapy was effective over time, as all the domains’ mean scores decreased considerably after treatment. The total mean score before prolotherapy was 21.20, which was extensively reduced to 13.08 after prolotherapy (p=0.001). There was statistically significant improvement in all domains, including functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap (p≤0.005 in all cases). We concluded that prolotherapy has a promising role in the improvement of OHRQoL of patients with TMD, and its beneficial effects persist at least two years after treatment.     

Association between maximum mouth opening and area of bony fusion in simulated temporomandibular joint bony ankylosis

The aim of this study was to investigate the quantitative association between active/passive maximum mouth opening (AMMO/PMMO) and the severity of simulated temporomandibular joint (TMJ) bony ankylosis. Twenty-eight male sheep were divided randomly and equally into surgical and control groups. Surgical group animals underwent bilateral TMJ osteotomy during which left lateral pterygoid muscle function was blocked. Control animals did not undergo surgery. Body weight, AMMO/PMMO, and TMJ morphological features were evaluated preoperatively and at 12 and 24 weeks post-surgery. In the surgical group, only the right TMJ complexes with maintained lateral pterygoid muscle function developed TMJ bony ankylosis. The AMMO/PMMO and end-feel distance in the surgical group were significantly lower than those in the control group (P < 0.001, both) at 12 and 24 weeks post-surgery. Moreover, AMMO (r = −0.940 and −0.952, P < 0.001, both) and PMMO (r = −0.944 and −0.953, P < 0.001, both) were negatively correlated with the area (mm²) of bony fusion post-surgery. These findings may be useful for the clinical treatment of early mandibular condyle fracture, with the use of occlusal pads/open-mouth plates to relax the lateral pterygoid muscle and block its function. When bony ankylosis developed in the TMJ, the greater the area of bony fusion, the more limited were AMMO/PMMO.     

Comparison between the radial forearm and groin soft tissue free flaps for reconstruction in patients with oral cavity cancer: a quality of life analysis

The purpose of this study was to compare the effects of the radial forearm free flap (RFFF) and groin soft tissue free flap (GSFF) on the quality of life (QoL) of patients undergoing reconstructive surgery after resection for oral cancer. A retrospective analysis of 48 patients was performed. The Vancouver Scar Scale (VSS), University of Washington Quality of Life (UW-QOL) questionnaire, and 14-item Oral Health Impact Profile (OHIP-14) questionnaire were used to evaluate the donor site scars and QoL of the patients. The postoperative hospital stay was significantly longer in the RFFF group than in the GSFF group (P = 0.001). Furthermore, the total VSS score (P = 0.011), VSS score for pigmentation (P < 0.001), and OHIP-14 scores for psychological discomfort (P = 0.026) and social disability (P = 0.044) were all significantly higher in the RFFF group than in the GSFF group, while the UW-QOL scores for appearance (P = 0.037) and mood (P = 0.036) were significantly lower in the RFFF group than in the GSFF group. Compared with the RFFF, the GSFF scar is more concealed, with better aesthetics at the donor site, and this flap can result in improved postoperative QoL for patients with oral cancer.     

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

IntroductionTemporomandibular 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. Materials and MethodsA 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 6 month postoperative), pain during physiotherapy, donor and surgical site complications and recurrence of ankylosis.ResultsThe mean maximum inter-incisal opening in dermis-fat group was significantly higher than temporalis group both at immediate and 6 month 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.ConclusionDermis-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.     

口腔癌患者健康相关生活质量及其影响因素调查

目的:调查口腔恶性肿瘤患者手术后生活质量状况及其影响因素。方法:选择郑州大学第一附属医院口腔颌面外科2011年5月~2013年1月收治的85例口腔恶性肿瘤患者,使用中文版口腔健康影响程度量表(oral health impact profile,OHIP-49)及华盛顿大学头颈肿瘤生活质量量表(University of Washington Quality of Life Scale,UW-QOL),在患者术后至少12个月后进行生活质量评测。结果:发出问卷85份,回收76份,完成问卷调查89.4%。UW-QOL调查问卷得分最高的项目是疼痛(77.3±6.3)分,其次是焦虑(76.4±7.8)分,第三是活力(74.3±8.2)分;得分最低的3项依次是:咀嚼(34.5±8.3)分、唾液(46.4±4.8)分、味觉(49.9±3.9)分。OHIP-14量表得分最好的项目是残障(38.5±7.4)分,其次是生理性疼痛(46.8±10.2)分,第三是心理障碍(50.9±5.8);得分差的3项依次是:功能限制(62.4±12.3)分、心理不适(57.8±9.2)分、社交障碍(55.8±12.8)分。结论:口腔癌根治性治疗对患者生活质量有显著的影响。对口腔恶性肿瘤应切实做好疾病护理,同时加强营养支持和心理疏导,并加强社会支持。     

Temporomandibular joint replacement: a New Zealand perspective

Alloplastic total temporomandibular joint replacement (TMJ TJR) has been performed in New Zealand utilizing the TMJ Concepts patient-fitted system since 2000. The data analysed in this study were collected retrospectively from questionnaires sent to all maxillofacial surgeons in New Zealand who had implanted TMJ Concepts devices between 2000 and 2011. A total of 63 devices were implanted in 42 patients (13 males, 29 females) during this 12-year period. The primary indication for TMJ TJR was end-stage joint disease resulting from ankylosis and arthritis. The mean age of the patients was 47 years (range 7–80 years). The most common complication reported was transient facial nerve impairment in 4.8% of the patients. Objective results, measured as the maximal incisional opening, improved by a mean of 17.3 mm (P < 0.01); 90% of patients reported improved quality of life. New Zealand oral and maxillofacial surgeons have concluded that TMJ TJR using the TMJ Concepts prosthesis is a reliable treatment option for the management of end-stage TMJ disease.     

Survey of patient experiences of orthognathic surgery: health-related quality of life and satisfaction

The objective of this study was to assess changes in patient quality of life (QoL) after orthognathic surgery at the Kuwait University Dental Clinic. A self-administered Arabic version of the Orthognathic Quality of Life Questionnaire (OQLQ) and two different visual analogue scales (VAS) were used. Sixty-six patients participated (63.6% female). The deformities were corrected by bimaxillary jaw surgery (83.3%), Le Fort I (9.1%), and bilateral sagittal split osteotomy (7.6%). The most important reasons given for undertaking the surgery were facial aesthetics (80.3%) and bite correction (75.8%). Of the patients who had reported moderate to high levels of problems pre-surgery, the majority reported improvements in facial appearance (91.3%), appearance of the teeth (97.0%), biting (96.3%), chewing (92.3%), and eating function (76.5%). Overall, 93.9% of patients reported better conditions after surgery, and the satisfaction level was very high (VAS 91.6%). The VAS score for QoL increased significantly from pre-surgery (73.0%) to post-surgery (93.6%) (P = 0.0001). The OQLQ score was also significantly decreased after surgery, reflecting improvements in the ‘social aspects of dentofacial deformity’, ‘facial aesthetics’, ‘oral function’, and ‘awareness of dentofacial aesthetics’ domains (P = 0.0001). Overall, the patients who underwent orthognathic surgery were satisfied and had improved QoL. The satisfaction rate in the present study reflects successful treatment with orthognathic surgery.     

Health-related quality of life in Nigerian patients with facial trauma and controls: a preliminary survey

We examined the health-related quality of life (HR QoL) of patients with facial trauma and compared it with that of healthy controls; temporal changes in HR QoL of patients over 12 weeks compared with baseline values; and whether the risk of depression could be identified by baseline HR QoL. For 26 months we recruited 126 consecutive patients with facial injuries and 126 age and sex-matched healthy controls for the study. Enrollment criteria included age 18 years and over, Glasgow coma scale score on admission of 12 and over, and duration of stay of more than 24 hours. HR QoL was measured using the 26-item World Health Organization Quality of Life Questionnaire (WHO QoL-Bref), and depression was measured with the Hospital Anxiety and Depression Scale (HADS). Scores in all domains of the WHO QoL-Bref (physical, psychological, social relations, and environment) were considerably reduced in injured patients compared with controls. During follow up there were improvements only in the domains of physical health and environment, but not in psychological health. There was a significant reduction in the HR QoL domain of social relationships with time. The regression equation for all four QoL domains as predictors was significantly related to depression scores throughout the study period. Patients with facial injuries are at risk of poor QoL after trauma. There was a high incidence of depression throughout the follow-up period, and poor QoL at baseline predicted depression during follow-up.     

Treatment modalities of TMJ ankylosis: experience in Delta Nile,Egypt

The study reports the authors’ experience in managing TMJ ankylosis in Delta Nile, Egypt (1995–2006) and compares the surgical modalities used. 101 patients (109 joints) were reviewed in this retrospective study. Pre- and postoperative assessment included history, radiological and physical examination, and mouth opening. Age, sex, aetiology, joint(s) affected, surgical modality, complications and follow up periods were evaluated. Various types (fibrous, fibro-osseous and bony) of TMJ ankylosis were diagnosed; trauma was the commonest aetiology. The patients’ age range was 2–41 years, 62% were female, and the follow up period ranged from 14 to 96 months. Average mouth opening was significantly increased from 5.3 mm pre-operatively to 32.9 mm 12 months postoperatively (P = 0.0001). Marked improvement in mouth opening was documented when the ramus-joint complex was reconstructed using distraction osteogenesis (34.7 mm), costochondral graft (34.4 mm) and Surgibone (34.6 mm). Gap arthroplasty showed least satisfactory mouth opening compared with other techniques (P = 0.001). Minor and major complications were encountered in 33% of cases, including 5% recurrence rate. Early release of TMJ ankylosis; reconstruction of the ramus height with distraction osteogenesis or bone grafting combined with interpositional arthroplasty, followed by vigorous physiotherapy is successful for managing TMJ ankylosis.     

牵张成骨在颞下颌关节强直及其继发畸形矫治中的应用

儿童时期发生的颞下颌关节强直可以导致不同程度的颌面部骨骼发育障碍,并引起自卑、社交障碍等一系列心理问题,其矫治是口腔颌面外科医生面临的一大挑战. 牵张成骨( distraction osteogenesis,DO)一直被国内外学者用于颞下颌关节(temporomandibular joint,TMJ)强直及其继发畸形的矫治,并取得了良好的临床效果.笔者所在科室每年大概收治50~60例TMJ强直患者,对DO技术在TMJ强直及其继发畸形矫治中的应用积累了较为丰富的临床经验. 本文中,笔者对DO技术在TMJ强直及其继发畸形矫治中的优缺点及相关问题进行述评.     

股前外侧穿支皮瓣修复口腔癌术后缺损患者的生活质量评估

目的 评估应用游离股前外侧穿支皮瓣（ALTF）修复口腔颌面部恶性肿瘤切除术后组织缺损患者的生活质量（QOL）。方法 以2012年1月-2013年7月应用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损的32例患者为研究对象,应用口腔健康影响程度量表（OHIP-14）和简明健康状况调查问卷（SF-36）对患者术后12个月的QOL进行调查和评估。结果 SF-36问卷得分位于前3的项目是躯体疼痛、生理功能和躯体角色,得分分别是78.58±14.82、72.08±27.86和60.00±42.63;得分较低的是情感角色（41.67±39.62）、心理健康（50.75±13.07）和健康变化（54.17±21.75）。分析OHIP-14量表得分,恢复较好的项目是社交障碍和残障,得分分别为34.50±11.32和36.04±12.05;恢复较差的项目是生理性疼痛和心理不适,得分分别为73.50±18.96和60.17±25.66。结论 采用ALTF修复口腔颌面部恶性肿瘤切除术后组织缺损,能够恢复患者外形、语言和咀嚼功能的基本需求,提高患者的QOL。     

The impact of a surgery-first approach on oral health-related quality of life

Orthognathic surgery using a surgery-first approach (SFA) has been shown to result in better quality of life (QoL) throughout the treatment duration; however, the effects of gender, age and type of dentofacial deformity on SFA-related QoL remain unknown. In total, 228 consecutive patients underwent SFA for correction of dentofacial deformities (skeletal class III, bimaxillary protrusion and facial asymmetry). We assessed their QoL before surgery and at 1, 6 and 12 months after surgery using the Orthognathic Quality of Life Questionnaire (OQLQ). The results indicated a significant decrease in the total OQLQ, facial aesthetics and social aspect domain scores 1, 6 and 12 months after surgery. Among all domains, the greatest improvement was noted in the facial aesthetics domain. The oral function scores declined significantly immediately after surgery, but improved significantly 6 and 12 months after surgery; however, the awareness scores remained relatively stable. At each time point, women and the bimaxillary protrusion group exhibited a significantly higher total and specific domain scores. Patients aged 18–22 years exhibited lower total and four specific domain scores than older patients. Thus, QoL improves in all aspects, except awareness domain, by 12 months after SFA, but gender, age, and type of dentofacial deformity affect this improvement.     

Patient's satisfaction with facial appearance and psycho-social wellness after orthognathic surgery among Hong Kong Chinese using the FACE-Q

PurposeTo assess and compare the changes in satisfaction with facial appearance and psycho-social well-being in dento-skeletal class II and III patients after orthognathic surgery with the FACE-Q among Hong Kong Chinese.MethodsThe questionnaires for thirteen orthognathic-relevant FACE-Q scales, translated into Cantonese and validated, were administered to Hong Kong Chinese patients before and after orthognathic surgery in the short- and long-term, respectively. The assessed scales were categorized into four main domains: satisfaction with facial appearance, quality of life, patient's experience of care, and adverse effects.ResultsGenerally, highly significant (p < 0.001) improved FACE-Q scores were found in the long-term in the scales investigating the satisfaction with overall facial appearance, lower face and jawline, and chin. Although dento-skeletal class III patients demonstrated significantly improved satisfaction with their post-surgical nostril appearance (p = 0.003), this was not evident in dento-skeletal class II patients (p = 0.231). Nonetheless, both class II and class III subjects have also revealed significantly improved psychological well-being (0.003; <0.001) and social function (0.001; <0.001) in the long-term. Age was not found to be correlated with all scales for satisfaction of facial appearance.ConclusionPreviously validated Face-Q scales are valuable instruments to measure clinical outcomes, psychological well-being and social function in Cantonese speaking patients. Both Class II and Class III patients showed significantly improved satisfaction with facial appearance, psychological well-being and social function after orthognathic surgery regardless of skeletal pattern and gender, confirming findings in other ethnicities.     

An assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders: Correlation of treatment-related kinesiographic and pain changes in patients receiving temporomandibular joint injections

BackgroundThe authors conducted a study in patients with temporomandibular joint (TMJ) osteoarthritis to assess whether treatment-related changes in pain levels and chewing ability coincide with a change in jaw kinesiographic (KG) parameters.MethodsThe authors selected 34 patients with a diagnosis of TMJ osteoarthritis that met Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to undergo a cycle of five weekly arthrocentesis procedures with injections of 1 milliliter hyaluronic acid. They performed a permutation test to assess the correlation between changes across time (from baseline to end of treatment) in two clinical outcome parameters—pain level and chewing ability—and changes across time in the KG outcome parameters.ResultsThe authors observed improvement across time in both chewing ability (F = 8.328; P = .005) and pain level (F = 10.903; P = .002). The authors observed no significant changes in any KG variables. With minor exceptions, no significant correlations were shown between changes in the clinical and KG parameters during the treatment period.ConclusionsTreatment-related changes in pain levels and chewing ability in patients with TMJ osteoarthritis do not coincide with changes in KG parameters.Practical ImplicationsIf one assumes pain variables to be the primary outcome measures in assessing treatment of TMJ osteoarthritis, KG recordings of the jaw are not useful for monitoring TMJ osteoarthritis in the clinical setting.     

A pilot trial on the molecular pathophysiology of traumatic temporomandibular joint bony ankylosis in a sheep model. Part II: The differential gene expression among fibrous ankylosis,bony ankylosis and condylar fracture

ObjectiveThe purpose of the study was to preliminarily explore the differential expressions of a series of genes regulating bone formation in temporomandibular joint (TMJ) fibrous ankylosis, bony ankylosis and condylar fracture healing.MethodsThe cDNA from either the bony ankylosed callus or fracture callus of the 6 sheep, as described in the part I, were both used in the study. The differences of gene expressions between bony ankylosis and condylar fracture at 1, 3, and 6 months postoperatively were measured by real-time PCR, with 2 samples at each time point. In addition, another 2 sheep were added to have fibrous ankylosis induced on the right TMJ, and 1 sheep was sacrificed at 3 and 6 months after surgery, respectively. The differences of gene expressions between fibrous and bony ankylosis at 3 and 6 months postoperatively were measured by real-time PCR.ResultsBony ankylosis showed higher mRNA expression trends in Wnt2b, Wnt5a, β-Catenin, Lef1, CyclinD1, Runx2, Osterix, Sox9, Col10a1, Alp, Ocn, Bmp2, and Bmp7 compared to fibrous ankylosis, although no statistical analysis was performed due to the very small sample size. Whereas bony ankylosis showed a significant lower expression of Wnt5a, β-Catenin, Lef1, Runx2, Osterix, Sox9, Col10a1, Alp, Ocn and Bmp4 compared to condylar fracture at several time points (P < 0.05).ConclusionOur data provided a preliminary molecular evidence for the hypothesis that the development of traumatic TMJ bony ankylosis was the course of delayed bone healing or hypertrophic nonunion, and deserved to be further studied.