Nabeela Riaz, Tooba Saeed, Chanda Shehzadi.
A Single Institutional Experience of Management of Temporomandibular joint (TMJ) Ankylosis.
Pak J Med Health Sci Jan ;12(1):299-302.

Background: Temporomandibular joint (TMJ) ankylosis produces a restricted mouth opening , which may be the partial reduction or com plete immobility of jaw. Trauma, systemic disease, e.g. ankylosing spondylitis, local or systemic infections and rheumatoid arthritis are most commonly associated with TMJ ankylosis. Surgical interventions are made for the management of TMJankylosis . Aim: The main treatment option is considered as gap arthroplasty with or without the interposition material. Method: This study retrospec tively reviews 102 patients of TMJ ankylosis , these patients were managed in the oral and maxillofacial surgery department , Mayo Hospital Lahore from January 2012 to December 2016. Out of 102 patients 59 were male and 43 were females. 69(70%) patients were less than 14 years of age and 33(30%) patients were more than 24 years of age. The etiology of TMJ ankylosis was trauma in 99(98.5%) patients, congenital in 2(1%) patients and due to infection in 1(0.5%) patient and unilateral ankylosis was seen in 73(73%) patients while, 29(29%) patients were bilaterally ankylosed. 102 patients(100%), patients were presented with limited mouth opening. Facial deformity in 41(41%) patients, night snoring in 27(28 %) patients, obstructive sleep apnoea in 8(8%) patients. Gap arthroplasty with interposition of the temporalis fascia/muscle was done in all patients. Results : Postoperatively , 93 patients could be followed up during the period of one to five years. In 69(62%) cases, mouth opening was achieved 30mm while 26(24%) cases achieved less than 30mm. Respiratory symptoms were improved in all patients who had ankylosis of TMJ. Conclusion: The patients with TMJankylosis are frequently presented and treated in the Oral and maxillofacial surgery department of Mayo Hospital by gap arthroplasty with interpositional temporalis fascia/muscle flap followed by strict physiotherapy. According to results of our study, this protocol was demonstrated as an effective treatment of TMJ ankylosis.

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