TMJ Disorder (Ankylosis): Clinical feature, Radiology, Treatment

May 30, 2012 | By | Reply More

TMJ Disorder (Ankylosis): Clinical feature, Radiology, Treatment

History of Ankylosis Patient:

1. Trauma
2. Forceps delivery
3. Tuberculosis
4. Typhoid
5. Septicemia

Clinical feature:

1.Unilateral:

• Facial asymmetry
• Fullness or, roundness of the affected side of the face
• Flattening & elongation of the unaffected side
• Crossbite

2. Bilateral:

• Symmetrical & micrognathic mandible
• Typical bird face deformity with receding chin
• Oral opening may be 5 mm at best, & even nil
• Poor oral hygiene
• Class II malocclusion

Radiology:

1. Complete obliteration of the joint space
2. Normal TMJ anatomy is distorted
3. Complete bony consolidation replacing the joint space
4. Elongation of the Coronoid notch
5. Prominent antegonial notch
6. Body of the mandible is seen as a bow structure

Treatment of Ankylosis:

1. Surgery:
• Gap arthroplasty
• Interpositional arthroplasty
2. Aggressive resection and a gap of at least 1-1.5 cm is created
3. Ipsilateral coronoidectomy & temporalis myotomy
4. contralateral coronoidectomy & temporalis myotomy
5. lining of the glenoid fossa with temporalis fascia
6. reconstruction
7. early mobilization & aggressive physiotherapy 6 months post operatively
8. regular follow up
9. orthognathic & cosmetic surgery for the development of aesthetics.

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Category: Oral Surgery

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