Costochondral Graft as Interpositional material for TMJ Ankylosis in Children: A Clinical Study

Abstract

This study indicates that using costochondral grafts to reconstruct TMJ ankylosis in children provides a good result.

Management of temporomandibular joint ankylosis in Yemeni children by metatarsal bone grafts.

“…27 In the present study, acceptable results were found in 8 out of 10 cases using metatarsal bone grafts for the reconstruction of the joint after resection of the ankylosed joint, with adequate mouth opening of 35.6mm. These findings are consistent with those of Sharma et al 21 In their study, satisfactory results were achieved in 8 out of 10 cases, with sufficient mouth opening of 35mm in 8 subjects. However, the findings of the current study (35.6mm) were lower than reported by Landa et al 28 who showed that the post-operative interincisal aperture was 48.5mm.…”

“…This is particularly true of young children who are completely unable to open their mouth. 21 The treatment of TMJ ankylosis should start as soon as the condition is recognized to minimize the restriction of facial growth. 21,22 There are three basic surgical objectives in the treatment of TMJ ankylosis.…”

“…21 The treatment of TMJ ankylosis should start as soon as the condition is recognized to minimize the restriction of facial growth. 21,22 There are three basic surgical objectives in the treatment of TMJ ankylosis. These are to establish joint movement, to prevent relapse and to achieve normal growth and development.…”

“…However, the type of operation and treatment policy vary between countries. There are several ways of reconstructing the TMJ, such as autogenous (fibula, clavicle, sternoclavicular joint, iliac bone, metatarsal bone and metatarsal-phalangeal joint), [11][12][13][14][15][16][17][18][19][20][21] and alloplastic methods.…”

“…Furthermore, most authors agree that recurrence of ankylosis is less likely when something is interposed between the two cut bony surfaces. 21,29 Topazian 29 compared gap and interpositional arthroplasties and reported 53% incidence of recurrence, when the gap arthroplasty method was used without interposition. Therefore, interpositional arthroplasty involves creation of a gap, but in addition a barrier (autogenous or alloplastic) was inserted between the cut bony surface to minimize the risk of recurrence and to maintain the vertical height of the ramus.…”