Surgical treatment of temporomandibular joint ankylosis: Follow-up of 15 cases and literature review

ABSTRACT

Introduction: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment oftemporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence.Purpose: To report 15 cases treated by either gap arthroplasty, or the articular reconstruction technique using costochondralgrafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literaturereview.Methods: The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patientssubmitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre- and postoperativeassessment included a thorough history and physical examination to determine the cause of ankylosis, the maximalincisal opening, etiology and type of the ankylosis, recurrence rate and presence of facial nerve paralysis.Results: The mean maximal incisal opening in the preoperative period was 8.71 + 6.97 mm and in the postoperative periodit was 28.50 + 8.10 mm, the recurrence rate was 20% (n=3), and always occurred in ankylosis type IV.Conclusion: The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosisis shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function (AU)