title: Quantifying the outcome of surgical treatment of temporomandibular joint ankylosis: A systematic review and meta-analysis.
abstract: BACKGROUND
  Temporomandibular joint ankylosis results in restricted mouth opening due to a fibrous or bony (non-neoplastic) union of the mandibular head to the glenoid fossa. Early surgical treatment is recommended, but the ideal surgical technique is debated. Our objective was to quantify the effect of different surgical interventions on maximal (interincisal) mouth opening.
  
  
  METHODS
  The systematic literature search (1960-2015) was based on PubMed, Web of Science and the Cochrane Library. Pooled mean differences and 95% confidence intervals between pre-operative and post-operative maximal mouth opening (in mm) were calculated with random-effects meta-analyses. The surgical interventions were grouped according to increasing complexity: gap arthroplasty, interposition arthroplasty and reconstruction arthroplasty.
  
  
  RESULTS
  Thirty-eight articles were identified (1993-2015), including 1215 patients who underwent operations; 84% of the cases were caused by trauma, and 8% by infection. Gap arthroplasty (n=463), interposition arthroplasty (n=409) and reconstruction arthroplasty (n=293) resulted in improved maximal mouth opening of 26.2 mm (95% CI, 24.1-28.2), 26.7 mm (95% CI, 24.6-28.8) and 30.6 mm (95% CI, 28.7-32.5), respectively, and 28.7 mm overall (95% CI, 26.7-29.2). The mean pooled post-operative maximal mouth opening ranged between 33.0 and 36.1 mm.
  
  
  CONCLUSIONS
  The maximal mouth opening improved most after reconstruction arthroplasty, and least after gap arthroplasty. However, the post-operative maximal mouth opening was similar for all techniques.
authors.affiliation: School of Dental Medicine, Faculty of Medicine and Health Sciences (Head of Department: Guy De Pauw, MSc DDS PhD), Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: noemi.deroo@ugent.be.
authors.forename: Noëmi
authors.initials: N
authors.lastname: De Roo
authors.affiliation: School of Dental Medicine, Faculty of Medicine and Health Sciences (Head of Department: Guy De Pauw, MSc DDS PhD), Ghent University, De Pintelaan 185, 9000 Ghent, Belgium; Department of Head and Neck & Maxillo-Facial Surgery, Faculty of Medicine and Health Sciences (Head of Department: Hubert Vermeersch, MD PhD), Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Luc.Van.Doorne@azzeno.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Doorne
authors.affiliation: School of Dental Medicine, Faculty of Medicine and Health Sciences (Head of Department: Guy De Pauw, MSc DDS PhD), Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: aline_troch@hotmail.com.
authors.forename: Aline
authors.initials: A
authors.lastname: Troch
authors.affiliation: Department of Head and Neck & Maxillo-Facial Surgery, Faculty of Medicine and Health Sciences (Head of Department: Hubert Vermeersch, MD PhD), Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Hubert.Vermeersch@uzgent.be.
authors.forename: Hubert
authors.initials: H
authors.lastname: Vermeersch
authors.affiliation: Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery (Head of Department: Martin Backdahl, MD PhD), Karolinska Institutet, Norra Stationsgatan 67, 171 76 Stockholm, Sweden. Electronic address: nele.brusselaers@ki.se.
authors.forename: Nele
authors.initials: N
authors.lastname: Brusselaers
mesh_terms: D000844:Ankylosis / Q000601:surgery*; D001178:Arthroplasty; D006801:Humans; D008335:Mandibular Condyle / Q000601:surgery; D013704:Temporomandibular Joint / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroplasty; Meta-analysis; Mouth opening; Surgical treatment; TMJA; Temporomandibular joint ankylosis