Regeneration, Reconstruction & Restoration (Triple R)

Abstract

Introduction : Ankylosis of the temporomandibular joint (TMJ) is a disabling condition due to the fusion of joint to the base of skull and results in mouth opening limitation. Several surgical techniques have been described for treatment of this condition but no consensus has been reached. This study sought to assess the success of treatment with regard to long-term functional improvement and rate of complications in ankylosis patients during a 10-year period.

Materials and Methods: Patients who underwent unilateral or bilateral condylectomy without joint reconstruction during 2001-2011 in the Maxillofacial Surgery Department of Shariati Hospital were evaluated in this historical cohort study. The patients were recalled to ensure the accuracy of information in their medical records and were clinically examined. Improvement in their joint function and rate of complications were evaluated. Data were analyzed using Wilcoxon Signed rank test, multivariate tests, Mauchly's sphericity test and McNemar’s test.

Results: A total of 27 subjects (13 males and 14 females) with a mean age of 34.8 years and 6.1 years mean duration of follow-up were evaluated. The results of observation showed that trauma was the most common cause of ankylosis (63%). The most common type of ankyloses was fibrous (55.6%) and 55.6% of the patients had bilateral ankylosis. Maximum mouth opening (MMO), the amount of lateral movement and open bite significantly improved after the operation (P<0.001). Frontal, zygomatic and buccal nerves had been injured in 4, 4 and 3 patients, respectively during the operation.

Conclusion: Condylectomy without reconstruction significantly improves the TMJ function in patients with TMJ ankylosis with regard to MMO, the amount of lateral movement, maintenance of occlusion and the skeletal form.