Interposition arthroplasty in post-traumatic temporomandibular joint ankylosis: A retrospective study

Abstract

Temporomandibular joint ankylosis which is most frequently caused by trauma, presents with restriction in mouth opening in early stages and if children are the victim and not treated early, it presents with growth retardation of the involved mandibular side. Various methods are available for surgical correction. We have reviewed our experience with the efficacy of different interpositional materials in post-traumatic cases in our set up with special reference to temporal fascia over last three years. Twenty seven patients with history of trauma, mostly fall from height, have been studied. They were evaluated clinically and by computed tomography (CT) scan, orthopantogram and x- ray lateral oblique view. The most common age group was 10-15 years with mean 12.5 years and male to female ratio 1:2. Preoperative mouth opening (inter incisor distance) was 1-2 mm in 17 cases and 2-4 mm in 10 cases. We have used temporalis fascia in nine, costochondral graft in seven, silastic sheets in five and T-plates in six cases. Post-operatively, adequate mouth opening of 30-50 mm was observed in six months follow-up and more than 50 mm at one year follow up in 21 cases out of which nine cases have interpositional material as temporalis fascia alone. The postoperative period was uneventful in all cases and none required re-operation for recurrences. We conclude that interpositional arthroplasty, especially with pedicled temporal fascia, is the best method to prevent recurrences and establish good mouth opening and full range of jaw movements.

Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

“…In our study, males were slightly more affected than females with a male to female ratio of 1.4:1 which is in agreement with other studies [6,7,18]. The reasons for the male preponderance in our study may be attributed to the overactive nature of male babies as compared to the females.…”

Surgical Management of Tempromandibular Joint Ankylosis: An analysis of 20 cases

“…The temporalis fascia is autogenous, resilient, vascularized flap in the proximity to the joint, which allows a pedicle transfer of vascularized tissue into the joint area and makes it a viable alternative [14].…”

Interpositional Arthroplasty in the Treatment of Temporomandibular Joint Ankylosis: A Review of Literature

“…Tripathy [18] have used costochondral graft in 7, temporalis fascia in 9 and allopastic material in 11 patients. The postoperative period was uneventhful in all cases and none required reoperation for recurrence.…”

“…In these 3 studies the skin graft and dermal graft were advocated to have a minimal donor site morbidity because of primary closure. Although the main disadvantage of the method has a potential of developing an epidermoid cyst [18,19], Chossegros suggested the skin quality might implicate in the occurrence of this complication. Another important disadvantage of this method, it might not maintain ramus height adequately.…”