• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.17 no.2
• /
• pp.180-185
• /
• 1995

TMJ ankylosis is classified with true and false type. A true ankylosis is defined as any condition that produces fibrous or bony adhesions between the articular surfaces of the temporomandibular joint. The main causes of true ankylosis are trauma or infection. A false ankylosis results from pathologic conditions outside the joint that limit mobility of the mandible such as myogenic disorders, coronoid impingement or rare direct bony fusion between maxilla and mandible. The treatment of choice of TMJ ankylosis is surgical intervention. We experienced the male patient with complete mouth opening limitation since 45 years before. This patient has true TMJ ankylosis and rare bony synostosis between maxilla and mandible in the right posterior region. We performed surgical intervention and had a favorable result.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.38
• /
• pp.12.1-12.6
• /
• 2016

Background: Temporomandibular joint (TMJ) ankylosis can be accompanied by various degrees of functional and esthetic problems. Adequate mouth opening, occlusal stability, and harmonious facial form are the main goals of treatment for ankylosis. Distraction osteogenesis has proven to be an excellent treatment for lengthening the ramus-condyle unit. However, various timings for distraction have been suggested, and there is no consensus on selection criteria for performing the procedure in stages or simultaneously with other treatments. Case presentation: In this case report, concomitant intraoral distraction and gap arthroplasty was planned to treat TMJ ankylosis and associated facial asymmetry. After gap arthroplasty and 23 mm of distraction, the ramus-condyle segment was successfully lengthened and mouth opening range was significantly increased. The resultant interocclusal space was stably maintained with an occlusal splint for 4 months after distraction. Finally, good occlusion was achieved after prosthetic treatment. The remaining mandibular asymmetry was corrected with osseous contouring and augmentation surgery. The mouth-opening range was maintained at 35 mm 24 months after treatment. Conclusion: Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.6
• /
• pp.455-461
• /
• 2012

Ankylosing spondylitis (AS) is a chronic autoimmune disease mainly involving the axial skeleton. The pathology of the disease is usually found at the sacroiliac joint, and half of the patients experience cervical spine invasion, but eventually, the whole spine is affected. The involvement of the temporomandibular joint (TMJ) in AS has not been investigated very well. A review of the literature revealed that there are only a few studies of TMJ involvement in AS that combined clinical and radiographic examinations. These studies show widely different results, ranging between 4% and 32%. We experienced Bilateral osseous ankylosis of the jaw treated by total alloplastic joint replacement in AS, and offer a case report.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.41.1-41.6
• /
• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.6
• /
• pp.368-372
• /
• 2017

We conducted a retrospective study and reviewed the temporomandibular joint (TMJ)-related papers published in a leading international journal, Journal of Oral and Maxillofacial Surgery, between January 2014 and December 2015. The study was conducted to ascertain and compare the trends of articles being published in the years 2014 and 2015. A total of 28 articles were reviewed, of which most of the full-length articles were on clinical management and outcomes and the role of radiology. The bulk of the studies were prospective, and less interest was shown in experimental research. A thorough review and analysis thus gives the impression that there is a great need for well-designed clinical studies on TMJ.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.14 no.1
• /
• pp.61-69
• /
• 1984

For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosed as rheumatoid arthritis through the clinical, radiographic examination and laboratory findings. Temporomandibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

• Journal of Korean Physical Therapy Science
• /
• v.5 no.4
• /
• pp.717-728
• /
• 1998

The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.488-492
• /
• 2010

This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

• Imaging Science in Dentistry
• /
• v.32 no.2
• /
• pp.113-118
• /
• 2002

Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

• Imaging Science in Dentistry
• /
• v.30 no.3
• /
• pp.217-222
• /
• 2000

A 31-year-old male with the complaint of severe limitation of mouth opening was referred to our department of Chonbuk National University Hospital. The physical status of the patient was hyposthenic. Extraoral examination showed no condylar movement of the both temporomandibular joints, no pain, no facial swelling or paresthesia. Intraoral examination showed several cervical caries on the upper anterior teeth, and gingival swelling on the whole dentition. Transcranial view showed no condylar movement, and narrowing of joint spaces. Chest P-A view showed straightening of thoracic, lumbar spine, and squaring of vertebrae of the same spines. Conventional lateral radiograph of cervical spine showed calcification of the intervertebral ligament. Computed tomograph showed extensive bone formation between temporal bone and the condylar head at both sides. Laboratory findings showed positive reaction on HLA-B27 histocompatibility antigen and increased level of IgA, IgG, ESR. Based on the clinical, radiographic, and the laboratary findings, final diagnosis was made as bony ankylosis of the both temporomandibular joints secondary to ankylosing spondylitis.