Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification system

Abstract

This study aimed to describe the clinical features of different types of traumatic temporomandibular joint (TMJ) ankylosis. Seventy-one patients with 102 ankylosed joints were retrospectively reviewed and categorized into four groups according to the grades of severity: type I, non-bony ankylosis of the joint with almost-normal joint space; type II, lateral bony ankylosis marked by a normal joint space that coexists with a radiolucent line; type III, complete bony ankylosis of the joint characterized by only a radiolucent line; and type IV, extensive bony ankylosis without any radiolucent line. The period of ankylosis, maximal mouth opening (MMO), rate of complications, and histopathological changes were compared among groups. Intergroup comparison showed significant differences in the clinical features of MMO and the incidence of complications (p < 0.05). Younger trauma patients tended to develop more severe types of ankylosis than older patients. Additionally, long post-trauma periods were related to the development of severe ankylosis. MMO was highly negatively correlated with the severity of ankylosis. Significant differences were noted among the four types of ankylosis. Younger trauma patients with long post-trauma periods tended to develop more severe TMJ ankylosis, experience more complications, and face more challenges in treatment than older patients.

Multidetector computed tomography in preoperative planning for temporomandibular joint ankylosis: A pictorial review and proposed structured reporting format

“…Structured radiological reporting of TMJ ankylosis is essential for preoperative planning to reduce the risk of intraoperative complications or inadequate resection. This includes an assessment of the extent of fibrous or bony ankylosis and staging according to the classification proposed by Xia et al 10 Measurement of the ankylotic mass on MDCT provides an estimate of the amount of material required for interpositional gap arthroplasty. Vascular injury to the IMA can be avoided by knowing the distance between the ankylotic mass and the IMA.…”

“…The imaging appearance of TMJ ankylosis on CT has been variably described depending on age and the duration of the injury. Xia et al 10 proposed a classification of TMJ ankylosis corresponding to the stages of TMJ ankylosis on CT, as follows: stage 1, in which the glenoid fossa and condyle are clearly seen with no bony ankylosis and scattered callus can be seen ( Fig. 3A ); stage 2, in which lateral bony ankylosis of the joint is seen and the condyle is displaced medially, forming pseudoarthrosis with the glenoid fossa ( Fig.…”

Classification and surgical management of temporomandibular joint ankylosis: a review

“…TMJA is also classified as fibrous, bony, or mixed types according to the type of tissue growing within the joint 5 . Over the years several classification systems have been proposed for TMJA [4][5][6][7][8][9][10][11] , which are widely based on the radiographic extent of the ankylotic mass and the histologic features. Most of the classifications are modifications of the classification proposed by Sawhney 6 .…”

Methods of Airway securing in patients treated for temporonandibular joint ankylosis

“…The main clinical features of TMJ ankylosis are progressive limitation of mouth opening, facial deformity, and obstructive sleep apnea syndrome (10). The temporomandibular joint (TMJ) forms the cornerstone of craniofacial integrity and its ankylosis may cause major problems in daily food intake and difficult in chewing, impaired speech, facial appearance and psychological stress.…”