Temporomandibular joint ankylosis surgery in a child: case report

Temporomandibular joint ankylosis is one of the most significant disorders of the stomatognathic system because it causes pain associated with severe functional limitations, such as difficulty in chewing and psychological and clinical problems due to poor oral hygiene. These disorders are quite significant in children, since the treatment is even more complex due to the fact that the condylar region is a site of active growth. The earlier the diagnosis is established, the better the treatment prognosis. Ankylosis can be treated by interposition arthroplasty of the temporalis muscle fascia in conjunction with ipsilateral coronoidectomy. The purpose of the present study was to report a clinical case of temporomandibular joint ankylosis in a pediatric patient treated by interposition arthroplasty of the temporalis muscle fascia associated with coronoidectomy.     

Temporomandibular joint ankylosis: report of 14 cases

The authors present a review of 14 patients with temporomandibular joint ankylosis treated between March 1992 and February 1997. Etiology of the ankylosis was trauma in four patients, ear infection in two, systemic infection in one case, congenital in another, and unknown in six. Patients were divided into two groups, according to their age: 16 years and under and over 16 years of age. The basic principle of surgical treatment in both groups is ample access for osseous resection and coronoidectomy. Costochondral grafts were used in group one (nine patients), while interposition of a silicone block, was performed in the second group (five patients). Follow-up evaluations were from twelve to 53 months (average 28.2 months). One case of recurrence occurred in the first group and no recurrences in the second group. The average long-term mouth opening in both groups was 32.8 mm.     

Temporomandibular joint ankylosis

The reconstruction of a permanent functional joint and the provision for correction of any associated deformity are the aims of treatment of temporomandibular joint ankylosis. Methods which merely free the ankylosis, in our opinion, compromise the likelihood of achieving these aims.     

Temporomandibular joint disk fracture: a case report

A case of a patient with a fracture of the temporomandibular joint (TMJ) disk is reported. The patient presented with posterior bilateral open-bite and difficulty to chew due to lack of contact between the posterior teeth. Diagnosis of disk fracture of the right TMJ was made based on magnetic resonance imaging (MRI), with posterior displacement of the posterior fragment of the disk, causing the posterior open-bite, and anterior displacement of the anterior fragment of the disk. TMJ manipulation failed to reposition the posterior fragment of the disk, and the patient refused to undergo TMJ arthroscopy to try to remove it. After four months, the posterior open-bite was reduced, probably because of remodeling of the posterior TMJ capsule and extrusion of the molars and premolars. Contact with the patient was lost after that time.     

Treatment of temporomandibular joint ankylosis: a case report

Bony ankylosis of the temporomandibular joint (TMJ) in a male patient was not diagnosed until the patient reached his early teens, at which time the condition was treated with a costochondral graft. At the time of treatment, there was an expectation that further orthognathic surgery would be required to correct the skeletal deformity. However, with the release of the ankylosis and growth of the costochondral graft, a good functional and esthetic result was achieved without further surgery. It is important that family dentists be aware of the clinical signs and symptoms of TMJ ankylosis, to allow early diagnosis and treatment.     

Temporomandibular joint ankylosis: a review of 44 cases

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.     

Temporomandibular joint fibrous ankylosis following orthognathic surgery: report of eight cases

Undue pressure on the temporomandibular joint consequent to orthognathic surgery may result in fibrous ankylosis in the joint. Occurrence of this disorder may increase with the use of rigid internal fixation combined with 6 to 8 weeks of maxillomandibular fixation. Proper intraoperative placement of the proximal mandibular segment is the key to prevention of this complication, especially in high-risk joints.     

Temporomandibular joint ankylosis: an Indian experience.

Seventy-five condylectomy and coronoidectomy specimens of temporomandibular joint ankylosis in 61 patients were studied. Fourteen patients had bilateral ankylosis, six of whom had fibrous ankylosis on one side. There were two types of ankyloses: intra-articular and juxta-articular. Intra-articular ankylosis was seen only in reankylosis or in postinfective cases. Sixty-six cases were posttraumatic juxta-articular ankylosis. A rudimentary temporomandibular joint with an atrophic condylar articular surface was found in all juxta-articular ankyloses. The size of new bone in the specimens varied from 0.5 to 3 cm. Fusion of the extra-articular bone mass with tympanic plate was also observed. Contracture of temporalis muscle was noted in all the cases, which made excision of the coronoid processes mandatory in all the arthroplasties. Arthroplasty early in childhood did not hamper growth; instead, facial remodeling was enhanced.     

全身(远处)感染致颞下颌关节强直:1例报告及文献复习

颞下颌关节强直可由创伤、感染、退行性变及间隙缺损导致。其中以局部感染多见,而全身感染则罕见。本文报道1例因全身远处感染导致双侧颞下颌关节强直的患者,该35岁女性患者因开口困难近20年就诊,并于20年前出现包括颞下颌关节区的全身多处脓肿,CT显示髁突与颞骨融合。采用双侧颞下颌关节截除术及人工关节置换术治疗,术后3个月开口度达2.5 cm,患者获得了满意的进食及语言功能。     

Temporomandibular joint ankylosis: surgical treatment and long-term results

The surgical treatment of 26 patients with ankylosis of the temporomandibular joint, as well as various methods and materials used for functional restoration are described. The significance of radical removal of the ankylotic bone, as well as the advantages of the interpositioning of the lyophilized cartilage, are emphasized.     

Temporomandibular joint ankylosis: review of thirty-two cases.

I have reviewed aetiology, sex, age at time of treatment, clinical features, radiographic findings, anaesthetic techniques, surgical treatment, complications, and results in 32 patients with ankylosis of the temporomandibular joint. Trauma and infection were the commonest causes of ankylosis: 50% and 41%, (n = 13), respectively. The 21-30 year age group had the most trauma cases. Twenty (63%) of the patients presented with bilateral ankylosis. Failing to do jaw-opening exercises was the main cause of relapse.