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International Journal of Medical Research & Health Sciences (IJMRHS)
ISSN: 2319-5886 Indexed in: ESCI (Thomson Reuters)

Abstract

Surgical treatment of temporomandibular joint ankylosis: Skims experience of 105 cases

Author(s): Shakeel M, Imran M, Ahad B, Shafi M and Khan A

Ankylosis is a very common condition developed mainly after damage to mandibular condyles or temporomandibular joint (TMJ) at a growing age.Treatment of temporomandibular joint ankylosis is a challenge and suffers from a high incidence of recurrence. Although treatment of ankylosis has been tried as early as nearly 200 years ago, no single technique produced satisfactory results. To report our experience of 105TMJ ankyloses cases managed with different surgical modalities from 1999 to 2014 in our institute. The sample consists of all the patients who have been operated in our deptt. fortmj ankyloses using different surgical treatments from 1999 to 2014. Pre- and postoperative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximalincisal opening, type of the ankyloses and recurrence rate. The mean age was 15.4,12.4,13.6 and 14.3 years for gap arthoplasty, interpositional arthroplasty with CCG, Interpositional arthroplasty with acrylic spacer and Interpositional arthroplasty with temporalis myofacial flap respectively. Trauma was the only etiological factor in all the cases of the present study. Preoperative CTscans revealed various types of ankylosis, according to Sawhney’s classification (9), type I (n=21), type II (n=40), type III (n=49) and type IV (n=8). The mean maximal incisal opening (MIO) in the pre and post operative period was 10.2 and 38.3 in gap arthroplasty group,10.5 and 34.3 in interpositional arthroplasty with CCG group,15.3 and 28.7 in interpositional arthroplasty with acrylic spacer group and 7.1 and 38.4 in interpositional arthroplasty with temporalis myofacial flap group. The recurrence rate was 10% (n=3) in gap arthroplasty,2.63% in interpositional arthroplasty with CCG group,8.33% in interpositional arthroplasy with acrylic spacer group and no recurrence was observed in interpositional arthroplasy with temporalis myofacial flap group. The recurrence always occurred in ankylosis type IV in all groups.


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