Abstract

Dr. P.V. Samir*, Dr. P. Sivaram, Dr. Tulika Verma, Dr. Sibani Mallick, Dr. M. Jyoti and Dr. Kaushal Charan Pahari

ABSTRACT

Temporomandibular joint ankylosis results in multiple problems in development of an individual both physically and psychologically. Severe facial disfigurement or asymmetry in TMJ ankylosis is very distressing that can cause difficulty in breathing (dyspnoea), eating (dysphagia), speech (dysarticulation) and social reciprocation. Early ankylosis of TMJ in children deteriorates normal mandibular growth. Henceforth, early diagnosis along with immediate surgical intervention and management of TMJ ankylosis should be the necessity of the hour. True ankylosis is osseous or fibrous adhesion between the TMJ surfaces, limited within the articular capsule. Meanwhile, false ankylosis may be caused by conditions not directly related to the joint but due to factors like enlargement of the coronoid process, post surgical scars, irradiation, infection, etc. Formation of a bony mass replacing the articulation is archetypal pathology of TMJ ankylosis ensuing restricted mandibular movements. Consequently, its management emphasises on sufficient removal of bony mass and interpositioning some material between the left over ramus and skull base to allow free movement of the condyle. Interposition materials used can either be autogenous grafts (temporalis muscle and fascia, dermis, auricular cartilage, fascia lata, fat, and lyodura) or alloplastic materials (silastic, silicone, and various metals). Management of TMJ ankylosis requires an amalgamation of surgery and early physiotherapy to restore mandibular function and to prevent recurrence. Two critical issues ensuring successful results are the extent of bone resection and the choice of material if interposition is performed.