title: Autogenous Reconstructive Modalities of TMJ Ankylosis-A Retrospective Analysis of 45 Cases.
abstract: The study reports the authors' experience in managing temporomandibular joint (TMJ) ankylosis in Chennai, India (1995-2006) and compares the surgical modalities used. Forty-five patients (67 joints) were reviewed in this retrospective study. Pre- and post-operative assessment included history, radiological, physical examination, and range of mouth opening. Age, gender, aetiology, joint(s) affected, surgical modality, complications and follow-up periods were evaluated. Various types (fibrous, fibroosseous and bony) of TMJ ankylosis were diagnosed. Trauma was the commonest aetiology. The patients' age range was 2-50 years, 51.1 % were males and the follow-up period ranged from 14 to 96 months. Average mouth opening was significantly increased to 32 mm 12 months post-operatively. Mouth opening was compared following different interpositional materials like temporalis interpositioning (33 mm), costochondral graft (30.6 mm) and autograft (30 mm). Minor and major complications were encountered in 37.4 % of cases, including 6.7 % 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 a successful strategy for the management of TMJ ankylosis.
authors.affiliation: Edens Dental and Maxillofacial Hospital, Nagercoil, Tamil Nadu India.
authors.forename: Dhineksh
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Rajan Dental Institute, Radhakrishnan Salai, Mylapoor, Chennai, Tamil Nadu India.
authors.forename: Gunaselan
authors.initials: G
authors.lastname: Rajan
authors.affiliation: Research Wing, Christian Medical Centre, Vellore, Tamil Nadu India.
authors.forename: Uma
authors.initials: U
authors.lastname: Raman
authors.affiliation: Sree Mookambika Institute of Dental Sciences, Kulasekaram, Tamil Nadu India.
authors.forename: Jomy
authors.initials: J
authors.lastname: Varghese
keywords: Ankylosis; Autogenous grafts; Autogenous reconstruction; Autograft; Costochondral graft; Gap arthroplasty; Preauricular incision; TMJ ankylosis