Management of temporo-mandibular joint ankylosis using different surgical approaches

Abstract

Comparison of gap arthroplasty (GAP), interpositional arthroplasty (IAP) and distraction osteogenesis (DO) simultaneous with interpositional arthroplasty (DO+IAP) in management of TMJ ankylosis is of interest to dentists. The study comprised 36 individuals with TMJ ankylosis, 16 of whom were female and 20 of whom were male. Both prior to and following surgery, the maximum inter-incisal opening (MIO) and facial pattern were noted. The postoperative MIO was 33.23 ą 1.23mm, 35.24 ą 1.11mm and 38.24 ą 1.34mm in GAP, IAP and DO+IAP respectively. Data is statistically significant with high MIO observed in DO+ IAP technique and low MIO in GAP technique (p < 0.005). In addition to lengthening the mandible, concurrently processed interpositional arthroplasty alongside DO for TMJ ankylosis corrects gross asymmetry of the face, occlusal mal-alignment, midline change, and creates room for previously un-erupted teeth to emerge.