Temporomandibular joint reconstruction using costochondral graft.

Reconstruction of the temporomandibular joint (TMJ) after release of ankylosis by condylectomy is a challenging problem in maxillo-facial surgery. A successful reconstruction implies correct restoration of form and, in children, future symmetrical growth. Bilateral bony ankylosis of the temporomandibular joint in a female patient was diagnosed in the Oral and Maxillofacial Surgery Department of Bangabandhu Sheik Mujib Medical University (BSMMU) at the time when she had severe facial deformity with typical bird face appearance. The condition was treated with costochondral graft following a bilateral condylectomy. At the time of treatment, there was an expectation that further orthognathic surgery or bone grafting would be required to correct the skeletal deformity. However, with the release of the ankylosis and growth of the costochondral graft, a good functional and esthetic result can be achieved without further surgery. It is important that dentists be aware of the clinical signs and symptoms of TMJ ankylosis, to allow early diagnosis and treatment.