The study reports the authors' experience in managing temporomandibular joint (TMJ) ankylosis in Chennai, India (1995-2006 and compares the surgical modalities used. Forty-five patients (67 joints) were reviewed in this retrospective study. Pre-and post-operative assessment included history, radiological, physical examination, and range of mouth opening. Age, gender, aetiology, joint(s) affected, surgical modality, complications and follow-up periods were evaluated. Various types (fibrous, fibroosseous and bony) of TMJ ankylosis were diagnosed. Trauma was the commonest aetiology. The patients' age range was 2-50 years, 51.1 % were males and the follow-up period ranged from 14 to 96 months. Average mouth opening was significantly increased to 32 mm 12 months post-operatively. Mouth opening was compared following different interpositional materials like temporalis interpositioning (33 mm), costochondral graft (30.6 mm) and autograft (30 mm). Minor and major complications were encountered in 37.4 % of cases, including 6.7 % recurrence rate. Early release of TMJ ankylosis; reconstruction of the ramus height with distraction osteogenesis or bone grafting combined with interpositional arthroplasty, followed by vigorous physiotherapy is a successful strategy for the management of TMJ ankylosis.

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Central giant cell granuloma (CGCG) of bone constitutes about 7% of all benign lesions of the jawbones. CGCG, as described by Jaffe in 1953, is an idiopathic non-neoplastic proliferative lesion. The mandible anterior to the first molar is the frequently affected site, and has a tendency to cross the midline. Though CGCG is a benign reactive osseous lesion, it has been classified into two types based on its clinic-radiologic features into a slow growing asymptomatic, nonaggressive lesion, and an aggressive type encountered in younger patients which is painful and grows rapidly into a large size, perforating the cortex causing root resorption, and has a tendency to recur. We report a rare case of aggressive CGCG with massive destruction in molar region and angle of mandible.