• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.112-119
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• 2018

Objectives: Temporomandibular joint ankylosis (TMJA) is a joint pathology caused by bony and/or fibrous adhesion of the joint apparatus, resulting in partial or total loss of function. Materials and Methods: This is a retrospective study conducted between 2012 and 2016 in the northwest region of Nigeria. The data retrieved includes gender, age, etiology of ankylosis, duration of ankylosis, laterality of ankylosis, type of imaging technique, type of airway management, types of incision, surgical procedure, mouth opening, interpositional materials used, and complications. Results were presented as simple frequencies and descriptive statistics. Results: Thirty-six patients with TMJA were evaluated during the study period. There were 21 males (58.3%) and 15 females (41.7%), yielding a male:female ratio of 1.4:1. The patients' age ranged from 5 to 33 years with $mean{\pm}standard$ deviation ($13.8{\pm}6.6years$). Thirty-five cases (97.2%) were determined to be true/bony ankylosis, while only 1 case (2.8%) was false/fibrous ankylosis. Most of the TMJA cases (16 cases, 44.4%) were secondary to a fall. In our series, the most commonly utilized incision was the Bramley-Al-Kayat (15 cases, 41.7%). The mostly commonly performed procedures were condylectomies and upper ramus ostectomies (12 cases each, 33.3%), while the most commonly used interpositional material was temporalis fascia (14 cases, 38.9%). The complications that developed included 4 cases (11.1%) of severe hemorrhage, 1 case (2.8%) of facial nerve palsy, and 1 case (2.8%) of re-ankylosis. Conclusion: Plain radiographs, with their shortcomings, still have significant roles in investigating TMJA. Aggressive postoperative physiotherapy for a minimum of 6 months is paramount for successful treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.239-248
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• 2021

The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.297-303
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• 2013

Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.

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

• Imaging Science in Dentistry
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• v.32 no.2
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• pp.113-118
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• 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
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• v.30 no.3
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• pp.217-222
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• 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.

• The Journal of the Korean dental association
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• v.19 no.4 s.143
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• pp.375-380
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• 1981

Unilateral bony ankylosis of temporomandibular joint is not extremely rare. Treatment in all cases should be surgical. Considerable difficulty has been encountered by surgeons in the judgment of the planning of the treatment for anklosis; either by gap arthroplasty or by interposition arthroplasty. A recent review of the literautre reveals that many authors reported more of the interposition arthroplasty treatment because of no recurrence and the excellent results obtained. This 22-year-old Korean female, who had suffered from unilateral temporomandibular joint recurrent anklosis, was received an operation of ramus osteotomy followed by interpositional arthroplasty with using of thin gold plate. She formerly was received condylectomy twice at the age of 8 and 9, under the diagnosis of unilateral bony ankylosis due to trauma. My experience with alloplasty in unilaterally recurrent ankylosed T-M joint is presented here for her general and oral functional condition proved to be satisfactory after 4 years follow-up.

• The korean journal of orthodontics
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• v.23 no.3 s.42
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• pp.427-445
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• 1993

The ankylosis of temporomandibular joint occured by several causes directly developes TM joint disfunction, In cases with prolonged condylar ankylosis, especially at growing age the condylar ankylosis evokes malfunction of growth center area, and then developes the abnormal facial morphology and malocclusion. Therefore it must be cured. Almost authors have agreed to the necessity of surgical correction of the TMJ anylosis. but they did not decide the one surgical method to get the best result. The Tx. method suggested by many authors are the using interposition after resection of condyle to remain a lever of 3rd class in Mn. kinetics, the autogenous condylar graft and the alloplastic condylar graft. Some authors have got the satisfied results only with the condylectomy of the involved TMJ. This study also operated only the detachment of fibrous adhesion on ankylosed condylar side and then established occlusion in the case with the unilateral TMJ ankylosis and fibrous joint adhesion and facial asymmetry evoked after the fracture of condylar head at early age. This study got a improved mouth opening and a stable postsurgical result after 1 year. Also, this study reviewed many author's study about the chanracteristics, etiology, diagnosis and Tx. method for the ankylosis of TMJ.

• The Journal of the Korean dental association
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• v.10 no.3
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• pp.145-148
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• 1972

The authors have observed and treated the two patients with true bony ankylosis of temporomandibular joint in 16 years old school boy and 24 years old korean male. The ankylosed patients were treated by condylectomy and arthroplasty such as resin condylar head graft having been made into acrylic resin. 1. In 16 years old school boy, temporoandibular ankylosis of left side was surgical_y approached by condylectomy including coronoid process and posterior border of ramus and resin condylar head graft by means of interosseous wiring. 2. In 24 years old korean male, bilateral temporomandibular ankylosis was treted by bilateral condylectomies and resin condylar head grafts. 3. The mouth opening has been continued as 3-5cm since 13 months and 8 months before and facial appearances were very excellent.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.412-420
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• 2013

The literature on alloplastic total temporomandibular joint (TMJ) replacement is encouraging, with acceptable improvement of treatment outcomes in terms of both pain level and jaw function. This is a case report on patients who suffered from degenerative joint disease and ankylosis after mandibular condyle fracture or prior TMJ surgery and were treated by TMJ replacement with condyle prosthesis. We obtained good results from the procedures, including total TMJ replacement.