Treatment modalities of TMJ ankylosis: experience in Delta Nile, Egypt.
The study reports the authors' experience in managing TMJ ankylosis in Delta Nile, Egypt (1995-2006) and compares the surgical modalities used. 101 patients (109 joints) were reviewed in this retrospective study. Pre- and postoperative assessment included history, radiological and physical examination, and mouth opening. Age, sex, aetiology, joint(s) affected, surgical modality, complications and follow up periods were evaluated. Various types (fibrous, fibro-osseous and bony) of TMJ ankylosis were diagnosed; trauma was the commonest aetiology. The patients' age range was 2-41 years, 62% were female, and the follow up period ranged from 14 to 96 months. Average mouth opening was significantly increased from 5.3mm pre-operatively to 32.9 mm 12 months postoperatively (P=0.0001). Marked improvement in mouth opening was documented when the ramus-joint complex was reconstructed using distraction osteogenesis (34.7 mm), costochondral graft (34.4mm) and Surgibone (34.6mm). Gap arthroplasty showed least satisfactory mouth opening compared with other techniques (P=0.001). Minor and major complications were encountered in 33% of cases, including 5% recurrence rate. Early release of TMJ ankylosis; reconstruction of the ramus height with distraction osteogenesis or bone grafting combined with interpositional arthroplasty, followed by vigorous physiotherapy is successful for managing TMJ ankylosis.
Elgazzar
R F
RF
Faculty of Dentistry, University of Manitoba and Health Science Centre, Winnipeg, Manitoba, Canada. elgazzar@cc.umanitoba.ca
Abdelhady
A I
AI
Saad
K A
KA
Elshaal
M A
MA
Hussain
M M
MM
Abdelal
S E
SE
Sadakah
A A
AA
D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000209:etiology / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods; D001863:Bone Screws; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation; D001864:Bone Wires; D002356:Cartilage / Q000637:transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery; D019857:Osteogenesis, Distraction / Q000379:methods; D026741:Physical Therapy Modalities; D011183:Postoperative Complications; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D013703:Temporal Muscle / Q000637:transplantation; D013704:Temporomandibular Joint / Q000293:injuries; D013705:Temporomandibular Joint Disorders / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D018786:Bone Substitutes