Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases.
OBJECTIVE
The purpose of this study was to determine the cause of temporomandibular ankylosis and the long-term results of gap arthroplasty with coronoidectomy followed by immediate postoperative jaw exercises as a treatment of the condition.


METHODS
This retrospective study evaluated the cause of temporomandibular joint ankylosis and the 36-month postoperative results of gap arthroplasty in 50 patients (62 joints). The patients were divided into 2 groups; group I (aged 0-12 years) consisted of 29 cases (24 unilateral and 5 bilateral; 34 joints); group II (aged 13-30 years) consisted of 21 cases (14 unilateral and 7 bilateral; 28 joints). A postoperative jaw opening exercise regimen was followed. Descriptive statistics, the Wilcoxon signed rank test, and rank sum 2-sample (Mann-Whitney) tests were applied.


RESULTS
Trauma to the temporomandibular joint was documented as a major etiologic factor in 86% of cases. The 36-month postoperative mean maximal incisal opening was 30.62 mm (+/- 6.25 mm) for group I and 30.14 mm (+/- 3.9 mm) for group II. The P value in each group was highly significant for the Wilcoxon signed rank test; the Mann-Whitney test showed no difference between the groups, indicating that both groups had done well. The recurrence rate was 2%.


CONCLUSIONS
Trauma is the major cause of temporomandibular joint ankylosis in India. The long-term functional results of gap arthroplasty are satisfactory and comparable to those obtained through use of other treatments. Postoperative exercises play a crucial role in lasting success.
Department of Dental Surgery, All India Institute of Medical Sciences, New Delhi.
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Roychoudhury
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Parkash
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Trikha
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000209:etiology / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008334:Mandible / Q000601:surgery; D008446:Maxillofacial Injuries / Q000150:complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint / Q000293:injuries / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome