Intra-articular ramus ostectomy combined with costochondral grafting for the treatment of recurrent ankylosis of the mandible.
OBJECTIVE
This report seeks to demonstrate a technique for treating recurrent ankylosis of the mandible by creating a functional false joint at a level distal to the original joint.


METHODS
This is a retrospective study involving patients treated between 1999 and 2003. Under general anaesthesia the ramus was exposed via a submandibular approach and a block of bone was removed from it inferior to the sigmoid notch. Temporary intermaxillary fixation was applied. A costochondral graft was interposed between the resected ends of bone and secured with mini-plates. Postoperatively intermaxillary fixation was maintained for 3 days after which the jaw was actively mobilized.


RESULTS
The technique was used in the treatment of six patients with recurrent ankylosis of the mandible ranging in age from 9 to 38 years. Follow-up was between 1 and 4 years. All the patients had a satisfactory interincisal opening ranging from 25 to 35 mm.


CONCLUSIONS
The technique does not require the exposure of the ankylosed joint proper but instead creates a false and functional joint at a lower level. It also permits lengthening and advancement of the mandible.
Donkor
Peter
P
Oral and Maxillofacial Unit, Department of Surgery, School of Medical Sciences, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Sciences and Technology, PMB, KNUST Post Office, Kumasi, Ghana. petadonkor@yahoo.com
Acheampong
Alex Oti
AO
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000601:surgery*; D001860:Bone Plates; D001864:Bone Wires; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019248:Jaw Fixation Techniques / Q000295:instrumentation; D008297:Male; D008334:Mandible / Q000601:surgery*; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods; D010027:Osteotomy / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D012189:Retrospective Studies; D013704:Temporomandibular Joint / Q000503:physiopathology; D013705:Temporomandibular Joint Disorders / Q000601:surgery*