title: Outcome of amniotic membrane as an interpositional arthroplasty of TMJ ankylosis.
abstract: OBJECTIVE
  Temporomandibular joint ankylosis is a major disorder, mainly due to trauma and other reasons, which is responsible for the restriction of mandibular functional activities. The scope of the successful surgical correction of temporomandibular joint ankylosis with amniotic membrane is on the membrane's being an interpositional material which we found not to elicit any host reaction, is capable of functional adaptation, and is very economical. Our purpose is to show the amniotic membrane as a suitable, biocompatible, and interpositional material alternative to the other materials, thereby reducing donor site morbidity.
  
  
  METHODS
  A study was conducted in 13 patients with an age range of 10 to 35 years with unilateral and bilateral bony TMJ ankylosis confirmed by clinical and radiological evaluations. Preoperative and postoperative clinical assessments of TMJ functions were done. Amniotic membranes were collected from the tissue bank, sterilized by gamma radiation, and freeze-dried. Then, the prepared amniotic cap (10-15 layers of amniotic membrane) was placed over the condylar head and anchored loosely to the neck and the surrounding tissues with a 3/0 Vicryl suture.
  
  
  RESULTS
  Measurements of postoperative maximum interincisal opening was taken with scale among the 13 patients. Preoperative interincisal distances ranged from 0 to 15 mm, and preoperative and immediate postoperative were 33-45 and 25-32 mm, respectively. Postoperative follow-up of interincisal opening after 1-, 6-, and 12-month intervals was found from 32 to 35 mm. Lateral excursions (left and right), protrusive movements, and functional recovery were all satisfactory.
  
  
  CONCLUSIONS
  Amniotic membrane graft as an interpositional material in temporomandibular joint ankylosis can be a good alternative as to prevent reankylosis and recover functionality.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. mahmudanaz@gmail.com.
authors.forename: Mahmuda
authors.initials: M
authors.lastname: Akhter
authors.affiliation: Medical Officer, Dhaka Dental College, Dhaka, Bangladesh.
authors.forename: Niaz
authors.initials: N
authors.lastname: Ahmed
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors.forename: Md Raihan-Ul
authors.initials: MR
authors.lastname: Arefin
authors.affiliation: Department of Ophthalmology, BIRDEM.Shahbag, Dhaka, Bangladesh.
authors.forename: Mahbub-Us
authors.initials: MU
authors.lastname: Sobhan
authors.affiliation: Oral & Maxillofacial Surgery, Anwar Khan Morden Medical College, Dhaka, Bangladesh.
authors.forename: Motiur Rahman
authors.initials: MR
authors.lastname: Molla
authors.affiliation: Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors.forename: Mahammad
authors.initials: M
authors.lastname: Kamal
mesh_terms: D000293:Adolescent; D000328:Adult; D000650:Amnion; D000844:Ankylosis / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016378:Tissue Transplantation / Q000379:methods*; D055815:Young Adult
keywords: Amniotic membrane; Arthroplasty; Temporomandibular joint