Surgical management of temporomandibular joint ankylosis type III by retaining the displaced condyle and disc.
OBJECTIVE
This article proposes a hypothesis regarding the value of saving the fractured condyle and disc in their displaced position in ankylosis type III for optimal temporomandibular joint (TMJ) function and growth, and describes four cases treated in this manner.


METHODS
Four patients (three females and one male, 9 to 48 years old) with TMJ ankylosis type III of 3 to 8 years' duration, a maximal mouth opening of 15 to 19 mm, and severely limited lateral and protrusive movements were treated. The ankylosed sites were resected, leaving the displaced condyle and disc in their medial position.


RESULTS
Fifteen to 60 months after surgery, the patients had a maximal mouth opening of 44 to 50 mm, as well as better contralateral and protrusive movements. In addition, two young patients (9 and 11 years old) showed an improved facial symmetry.


CONCLUSIONS
Treatment of patients with type III TMJ ankylosis should involve retention rather than removal of the displaced condyle and disc. The condyle and disc are left untouched in their precarious medial position so as to provide normal function and growth.
Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah Schools of Dental Medicine and Medicine, Jerusalem, Israel.
D W
DW
Nitzan
J
J
Bar-Ziv
A
A
Shteyer
D000328:Adult; D000844:Ankylosis / Q000473:pathology / Q000601:surgery*; D001175:Arthrography / Q000379:methods; D002648:Child; D005146:Facial Asymmetry / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries / Q000601:surgery*; D008337:Mandibular Fractures / Q000601:surgery; D008875:Middle Aged; D016059:Range of Motion, Articular; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000473:pathology / Q000601:surgery*