Functional Outcomes of Gap and Interposition Arthroplasty in the Treatment of Temporomandibular Joint Ankylosis

Immediate versus Delayed Physiotherapy Protocol after the Management of Temporomandibular Joint Ankylosis by Conservative Gap Arthroplasty

“…Comparable results were also stated by many authors, who reported 15% of re-ankylosis after gap arthroplasty. (12,24,32) Re-ankylosis in this study was mainly due to lack of compliance with the mouth opening exercises as also reported by many authors explaining that recurrence was mainly related to inadequate performance of physiotherapy by the patient. (1,30,33) In addition, Cho et al (34) reported that the narrow gap width, as performed in this study, carries the risk of re-ankylosis.…”

“…Furthermore, the postoperative condition of the patients is more favorable because no donor site is required. Many authors (4,10,(22)(23)(24) compared the surgical outcomes of gap and interpositional arthroplasty and concluded that both methods showed comparable results regarding the MIO and recurrence rate. Katsnelson et al (8) compared the range of movement in patients treated by gap arthroplasty and joint reconstruction, and observed better MIO with gap arthroplasty.…”

“…Many authors observed that restoration of MIO and prevention of re-ankylosis depend mainly on radical resection of the ankylotic mass, aggressive postoperative physiotherapy, and good patient's cooperation with regular follow-up, regardless the selected surgical technique. (11,(24)(25)(26) The ideal width of the gap arthroplasty remains controversial. Many authors stated that to prevent re-ankylosis, aggressive bone removal of at least 1.5 cm is required.…”

“…Those patients had an open bite before surgery as a result of muscular pull and the patients' needs to push the food through the anterior teeth as also reported by many authors. (1,24,32) During the followup period, there was an improvement in the AOB and this could be attributed to the narrow gap, the application of light guiding elastics, and the patients were taught to push the chin upwards to close the AOB. This allowed remodeling of the stump of the ramus together with some degree of neuro-muscular reeducation as also reported by Temerek.…”

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

“…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.…”