Preservation of disc for treatment of traumatic temporomandibular joint ankylosis.
OBJECTIVE
A new operating method was used to treat traumatic temporomandibular joint (TMJ) ankylosis, to restore the structure of the TMJ, to improve the secondary maxillofacial deformity, and prevent recurrence of TMJ ankylosis.


METHODS
Thirty-six patients (20 females, 16 males; aged 5 to 54 years old) with TMJ ankylosis type II or III of 1 to 16 years' duration, with a maximal mouth opening from 0 to 15 mm preoperatively participated. The new method was to separate bony fusion between condyle and glenoid fossa, remove the condylar fragment that displaced medially or anteroinferiorly, mobilize the remains of the disc over the condylar stump and suture it with articular capsule, and shave the surface of the condylar stump and glenoid fossa smooth.


RESULTS
Follow-up was performed from 1 to 7 years postoperatively in 21 cases. No recurrences occurred in patients whose TMJ disc was retained during operation. Patients had an average maximal mouth opening of 33.7 mm postoperatively. An 11-year-old patient showed an improved facial symmetry after surgery.


CONCLUSIONS
By restoring the normal structure of the TMJ and preservation of the disc, recurrence of traumatic TMJ ankylosis and facial deformity in younger patients can be prevented.
Long
Xing
X
Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Key Laboratory for Oral Biomedical Engineering, Ministry of Education, Wuhan University, Wuhan, China. longxing_china@hotmail.com
Li
Xiaodan
X
Cheng
Yong
Y
Yang
Xuewen
X
Qin
Lizheng
L
Qiao
Yongmin
Y
Deng
Mohong
M
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000293:injuries / Q000601:surgery; D008337:Mandibular Fractures / Q000150:complications; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D016059:Range of Motion, Articular; D055502:Secondary Prevention; D013704:Temporomandibular Joint / Q000293:injuries* / Q000601:surgery*; D019224:Temporomandibular Joint Disc / Q000503:physiopathology* / Q000601:surgery