Treatment of temporomandibular joint ankylosis: gap and interpositional arthroplasty with temporalis muscle flap.
OBJECTIVE
The purpose of this study was to examine the effectiveness of gap and interpositional arthroplasty with temporalis muscle flap in the treatment of the temporomandibular joint (TMJ) ankylosis.


METHODS
This retrospective study was evaluated on 34 patients who were treated from February 2003 to July 2007. Diagnosis of TMJ ankylosis was based upon the clinical examination and plain radiography and CT scan. Eight patients (23.5%) had bilateral TMJ ankylosis, and four patients had reankylosis (that had been operated in another center). Trauma was the most etiological factor (88.2%) and osteochondroma of the condyle in one patient caused ankylosis.


RESULTS
Means of maximum mouth opening before and after operation were 5.00 (SD) 3.45 mm and 32.85 (SD) 5.51 mm, respectively. Reankylosis in two patients (5.9%) and facial nerve dysfunction in 12 surgery sides (28.5%) were noted.


CONCLUSIONS
The findings of this study suggest that the gap arthroplasty with temporalis muscle flap as interpositional graft is an effective method in the treatment of TMJ ankylosis. The osteoarthrectomy of the callus to create at least 10 mm gap and enough bulk of temporalis muscle flap as interpositional graft followed by at least a 6-month physiotherapy which play an important role in prevention of reankylosis.
Bayat
Mohammad
M
Department of Oral and Maxillofacial Surgery, Shariati General Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Badri
Amirali
A
Moharamnejad
Nima
N
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000601:surgery*; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000209:etiology; D013703:Temporal Muscle / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D055815:Young Adult