MANAGEMENT: TMJ ANKYLOSIS

  • Ankylosis can ONLY be treated surgically.
  • There is no form of pharmacological management.
  • Type of surgery depends on age of the patient & extent of deformity.
  • Treatment also varies if ankylosis is unilateral/bilateral.

SINGLE STAGE V/S 2-STAGE SURGICAL PROCEDURES:

  • Surgery can be done in two stages.
  • In the first operation, only a release of ankylosis is done.
  • It is believed that growth takes place after release of ankylosis.
  • Second stage procedure,an orthognathic surgery can be performed to restore esthetics.
  • Some, however prefer to it as a single stage procedure,where release of ankylosis + esthetic correction is done in a single stage operation in adults.

SURGICAL PROCEDURES:

There are 3 types:

  • Condylectomy.
  • Gap Arthroplasty.
  • Interpositional Arthroplasty.

TMJ APPROACHES:

SURGICAL APPROACHES TO THE TMJ:
P1 and P2— preauricular approaches;
PA-postauricular approach;
I—inverted hockey stick approach;
E -endaural approach.
R-retromandibular approach.

1. CONDYLECTOMY:

CONDYLECTOMY

2. GAP ARTHROPLASTY:

GAP ARTHROPLASTY

3. INTERPOSITIONAL ARTHROPLASTY:

AUTOGENOUS COSTCHONDRAL GRAFT

KABAN’S PROTOCOL:

REFERENCES:

  • Textbook of Oral & Maxillofacial Surgery, Chitra Chakravarthy (2nd Edition)
  • interchopen.com
  • researchgate.net

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