title: The sequential management of recurrent temporomandibular joint ankylosis in a growing child: a case report.
abstract: BACKGROUND
  Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible.
  
  
  METHODS
  This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed.
  
  
  CONCLUSIONS
  This is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.
authors: Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, 1071, Anyangcheon-ro, Yangchen-gu, Seoul, 07985 South Korea.
authors: Jung-Won
authors: JW
authors: Cho
authors: Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, 1071, Anyangcheon-ro, Yangchen-gu, Seoul, 07985 South Korea.
authors: Jung-Hyun
authors: JH
authors: Park
authors: Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, 1071, Anyangcheon-ro, Yangchen-gu, Seoul, 07985 South Korea.
authors: Jin-Woo
authors: JW
authors: Kim
authors: Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, 1071, Anyangcheon-ro, Yangchen-gu, Seoul, 07985 South Korea.
authors: Sun-Jong
authors: SJ
authors: Kim
keywords: Pediatric patient TMJ ankylosis; Recurrent ankylosis; TMJ ankylosis