Mandibular growth and mouth opening after two different surgeries in TMJ ankylosis: a one-decade assessment

ABSTRACT

The long-term outcome and clinical results of gaparthro plasty used for the treatment of condylar ankylosis of the mandible in children with application of postoperative activator appliances and costochondral rib graft are evaluated and compared. A nonrandomized, retrospective clinical study of 10 cases of condylar ankylosis [18 Joints] of the mandible surgically treated during a 12 year period from 1990 to 2002 was performed. Four patients were treated by condylectomy and interpositional Flap and Six patients were treated by condylectomy and immediate costachondral rib grafts. The First group underwent long-term postoperative therapy using removable activator appliances. Casts, radiagraphs, photographs, computed tomography [CT] Scans, were Used post surgically to evaluate rib graft, condylar growth and function, occlusion, and Facial and condylar symmetry. Symmetry, arch coordination, correction of occlusal canting, mandibular deviation, facial growth and prevention of reankylosis were obtained and better controlled in those cases that underwent long-tern or thodontic activator therapy post operatively and were followed closely. Children with long-standing condylar ankylosis of the mandible and its resultant facial asymmetry and occlusal canting [Secondry to a non functional jaint and Maxillary compensation] treated with condylectomy and interpositional flap treated more favorably when activators were used postsurgically. The patients that failed to comply with or continue activator therapy postsurgically developed complications relating to mandibular deviation, occlusal dysharmony, asymmetry and rankylosis of the temporo mandibular joint [TMJ]