Temporomandibular Joint Ankylosis In Children

Abstract

Temporomandibular joint (TMJ) ankylosis is defined as osseous or fibrous fusion of the condyle of the mandible and the mandibular fossa of temporal bone (Nitzan et. al. 1998).It is a debilitating disease that renders the afflicted person unable to use their oral cavity well. Clinical presentation depends on the age at which ankylosis occurs and whether ankylosis is unilateral or bilateral. Surgery and postoperative physiotherapy are regarded as the mainstay treatment for TMJ ankylosis. The study reviews surgical outcomes of 13 children treated for temporomandibular joint (TMJ) ankylosis in the maxillofacial and oral surgery unit at Red Cross Children's Hospital. Nine patients were treated by gap arthroplasty, while four patients had previous reconstruction with costochondral graft. One patient treated by gap arthroplasty reankylosed. The study showed a positive correlation between intraoperative MIO and the outcome, and between age and the outcome. Mouth opening was improved by 15mm, with postoperative change of-4mm.

A systematic review and meta-analysis of the clinical outcomes for various surgical modalities in the management of temporomandibular joint ankylosis

“…15,25,[34][35][36][37][38][39][40][41][42][43][44][45][46][47] Of the 16 studies included, eight 25,34-40 compared GA to IPG with respect to MIO and recurrence, four 15,34,41,42 compared IPG to CCG with regard to MIO and recurrence, and two 43,44 compared GA to CCG with regard to recurrence. Lastly, three studies 45-47 compared CCJ and AJR with regard to MIO and pain.…”

“…This in agreement with other results. 38,43,44 Concerning the methodological quality of the studies included, 12 studies 15,25,34,[36][37][38][39][40][41][42]46,47 were of good quality (low risk of bias) and four 35,[43][44][45] were of fair quality. In this context, seven studies 35,36,[38][39][40][41][42] were CCTs and nine studies 15,25,34,37,[43][44][45][46][47] were retrospective.…”

“…Thus, a total of 16 articles were included in the review. 15 articles compared the GA to CCG groups with regard to recurrence rate 43,44 ; and three [45][46][47] compared CCJ to AJR with regard to MIO and pain. One study (Tanrikulu et al 34 ) was used in two comparisons (GA vs. IPG and IPG vs. CCG) because it assessed these three groups for MIO and recurrence.…”

“…43,44 Both were RS and were included in the meta-analysis with regard to recurrence (re-ankylosis). A total of 28 patients were enrolled in these studies, with 19 in the GA group and nine in the CCJ group.…”

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

“…In addition, as the result of insufficient nutrition, the children's development remains behind their counterparts. [2][3][4] The most common cause of TMJ ankylosis is trauma or infection. The incidence of TMJ ankylosis due to trauma ranges from 26% to 75%.…”