Modified coronoid process grafts combined with sagittal split osteotomy for treatment of bilateral temporomandibular joint ankylosis

Purpose: This article describes the use of autogenous coronoid process grafts for lengthening the ramus in patients with long-standing temporomandibular joint (TMJ) ankylosis and severe mandibular retrognathia. Patients and methods: A retrospective clinical study of 6 cases of bilateral TMJ ankylosis surgically treated during a 3-year period from June 1996 to March 1999 was performed. All patients were treated by condylectomy, mandibular sagittal split osteotomy, and immediate autogenous coroniod process grafts. Clinical examination, radiographs, and photographs were used postsurgically to evaluate the grafts, condylar function, and facial appearance. Results: Very satisfactory postsurgical results were obtained in terms of function of the TMJ, the airway, and aesthetics. Conclusion: In children suffering from TMJ ankylosis, the coronoid process can be used for mandibular lengthening. (C) 2002 American Association of Oral and Maxillofacial Surgeons.