A clinical study on ankylosis of the temporomandibular joint

Introduction: Restoration of normal function and jaw movement in patients with temporomandibular joint (TMJ) ankylosis is difficult. Various techniques have been defined for the treatment of the condition. Patients: This study is based on the pre-, intra- and post-operative evaluation of 78 TMJ operations in 59 patients who were treated for TMJ ankylosis between 1985 and 2002. Methods: The patients in this study were evaluated with regard to age, gender, aetiology of ankylosis, ankylosis type/classification, existing facial asymmetry, maximal pre- and post-operative mouth opening, the arthroplasty methods (gap and interpositional arthroplasty) including complications and recurrence of ankylosis. Results: Falls represented the most widespread aetiological factor (85%), and women constituted the group with the highest incidence of ankylosis (61%). Forty cases were unilateral (68%) and 19 bilateral (32%); 82% (64 joints) were of the bony type. Gap arthroplasty was applied in 34 of the 59 cases (58%) and interpositional arthroplasty in the remaining 25 (42%). Pre- and post-operative mean mouth opening were 3.5 +/- 1.7 and 30.7 +/- 3.0 mm, respectively. Re-ankylosis was noted in 5%. Conclusion: In addition to radical and sufficient resection of the ankylosed bone, early postoperative exercises, appropriate physiotherapy and close follow-up of the patient play an important role in the prevention of post-operative adhesions and re-ankylosis. (c) 2005 European Association for Cranio-Maxillofacial Surgery