title: Two-stage total prosthetic reconstruction of temporomandibular joint in severe and recurrent ankylosis.
abstract: Temporomandibular joint ankylosis is a devastating condition for the patient associated with both functional disability and aesthetic deformities. Various techniques have been described in the literature to overcome this problem; however, there is still a high risk of reankylosis in patients undergoing multiple temporomandibular joint operations, severe heterotopic ossification, and fibrosis of the soft tissues. This study includes 5 patients with severe and recurrent ankylosis. Two-stage reconstruction with excision of the bony mass and placement of a distraction device in the first stage, followed by gradual distraction of soft tissues, and placement of a total joint prosthesis in the second stage were performed in all patients. The 2-step approach helps to overcome the fibrosis and adhesions in the soft tissues and allows placing an implant with a higher ramus component. This approach seems to be a useful and effective technique for the management of such patients with high risk of reankylosis.
authors.affiliation: Okmeydani Training and Research Hospital, Plastic and Reconstructive Surgery Clinic, Istanbul, Turkey. onuregemen@hotmail.com
authors.forename: Onur
authors.initials: O
authors.lastname: Egemen
authors.forename: Ozay
authors.initials: O
authors.lastname: Ozkaya
authors.forename: Gaye Taylan
authors.initials: GT
authors.lastname: Filinte
authors.forename: Ilker
authors.initials: I
authors.lastname: Uscetin
authors.forename: Mithat
authors.initials: M
authors.lastname: Akan
mesh_terms: D000293:Adolescent; D000328:Adult; D000844:Ankylosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed