INTRODUCTION: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular 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 costochondral grafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literature review. METHODS: The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patients submitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre-and post-operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal 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 period it 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 ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.
INTRODUCTION:Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular 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 costochondral grafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literature review. METHODS: The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patients submitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre-and post-operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal 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 period it 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 ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.
Authors: Manuel Fernandez Dominguez; Jose Luis Del Castillo; Mario Muñoz Guerra; Ruth Sanchez Sanchez; Maria Mancha De La Plata Journal: Craniomaxillofac Trauma Reconstr Date: 2014-10-27