Preservation of condyle and disc in the surgical treatment of type III temporomandibular joint ankylosis: a long-term follow-up clinical study of 111 joints

Abstract The purpose of this study was to establish the role of retaining the condyle and disc in the treatment of type III ankylosis, by clinical and computed tomography (CT) evaluation. A total of 90 patients with type III ankylosis met the inclusion criteria; 42 patients had left temporomandibula...

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Published in:	International journal of oral and maxillofacial surgery Vol. 42; no. 6; pp. 746 - 751
Main Authors:	Jakhar, S.K, Agarwal, M, Gupta, D.K, Tiwari, A.D
Format:	Journal Article
Language:	English
Published:	Denmark Elsevier Ltd 01-06-2013
Subjects:	Adolescent Adult Ankylosis - pathology Ankylosis - surgery Child Dentistry Female Follow-Up Studies Humans Male Mandibular Condyle - diagnostic imaging Mandibular Condyle - physiology Mandibular Condyle - surgery Maxillofacial Injuries - complications Physical Therapy Modalities Range of Motion, Articular Secondary Prevention Surgery Temporomandibular Joint Disc - diagnostic imaging Temporomandibular Joint Disc - physiology Temporomandibular Joint Disc - surgery temporomandibular joint disorder Temporomandibular Joint Disorders - etiology Temporomandibular Joint Disorders - pathology Temporomandibular Joint Disorders - surgery Tomography, X-Ray Computed treatment of TMJ ankylosis type III TMJ ankylosis Young Adult type III TMJ ankylosis temporomandibular joint disorder treatment of TMJ ankylosis
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Summary:	Abstract The purpose of this study was to establish the role of retaining the condyle and disc in the treatment of type III ankylosis, by clinical and computed tomography (CT) evaluation. A total of 90 patients with type III ankylosis met the inclusion criteria; 42 patients had left temporomandibular joint (TMJ) ankylosis, 27 patients had right TMJ ankylosis, and 21 had bilateral TMJ ankylosis, thus a total 111 joints were treated. Considerable improvements in mandibular movement and maximum mouth opening were noted in all patients. At the end of a minimum follow-up of 2 years, the mean inter-incisal mouth opening was 30.7 mm. Postoperative occlusion was normal in all patients, and open bite did not occur in any case because the ramus height was maintained through preservation of the pseudo-joint. Only three patients had recurrence of ankylosis, which was due to a lack of postoperative physiotherapy. The advantages of condyle and disc preservation in type III ankylosis are: (1) surgery is relatively safe; (2) the disc helps to prevent recurrence of ankylosis; (3) the existing ramus height is maintained; (4) the growth site is preserved; and (5) there is no need to reconstruct the joint with autogenous or alloplastic material. It is recommended that the disc and condyle are preserved in type III TMJ ankylosis.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0901-5027 1399-0020
DOI:	10.1016/j.ijom.2013.02.002