TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement—A Case Report

Abstract

This report describes the multidisciplinary phasewise treatment of a 20-year-old female patient having unilateral right TMJ bony (true) ankylosis whose mouth opening was restricted to 2 mm and mandibular retrognathism; additionally, she was also suffering from speech problems, snoring, difficulty in breathing, and low level of self-esteem and self-confidence. Bilateral gap arthroplasty and temporalis myofascial graft interpositioning through preauricular approach were done in surgical phase followed by the aggressive jaw physiotherapy in postsurgical period. Oral prophylaxis and restorations were followed by the fixed orthodontic therapy to resolve bimaxillary protrusion. Advancement sliding genioplasty was performed to enhance the chin button. Speech therapy and psychological counseling were also performed from time to time to boost up the self-esteem and self-confidence. At the end of treatment, facial esthetics was improved considerably and patient got over the impact of disfigurement, impaired functions, and psychosocial stigma. Rationale to use the multidisciplinary team approach in treatment of such cases is discussed.

Functional and Aesthetic Outcome Following Simultaneous Temporomandibular Joint Ankylosis Release and Correction of Chin Discrepancy by Lower Border Osteotomy-A Case Report

“…Patient was having reduced mouth opening and facial disfi gurement because of which she was not able to present herself confi dently in the society. Although some surgeons recommend a staged approach for the treatments of patients with TMJ ankylosis and related secondary deformities, others prefer to release the ankylosis and correct the deformities simultaneously [3,[7][8][9]. The results were acceptable but due to distraction there is change in the occlusal plane which requires more vigorous orthodontic treatment and time [10][11][12][13].…”

“…Eventhough TMJ ankylosis when addressed at an early age which corrects the mouth opening but the facial asymmetry which is a result of this requires a second surgery for its correction. These problems not only eff ect the patient aesthetically and functionally but also creates a psychological trauma to the patient leading to a low self esteem life [3]. There are various surgical procedures for correction of facial asymmetry like genioplasty, distraction osteogenesis, orthomorphic and orthognathic surgeries [4].…”

Vascularized Treatment Options for Reconstruction of the Ascending Mandible With Introduction of the Femoral Medial Epicondyle Free Flap

“…[104][105][106][107] However, the diversity of treatment options available to reconstruct the ascending mandible alludes to the difficulty of obtaining excellent long-term results in the surgical arena. Given its importance, mandibular reconstruction needs to be conceptualized as a long-term rather than shortterm solution.…”

Bilateral TMJ ankylosis, anesthetic and surgical challenge- case report

“…Facial asymmetry develops if only one side is affected. Disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability [5]. Severity of ankylosis is diagnosed clinically by evaluating the degree to which mouth opening is restricted.…”