IJSR - International Journal of Scientific Research

Ramesh K; Khadar Vali Shaik; Haripriya Chari; Ashok kumar; Kiran kumar

Volume : VI, Issue : X, October - 2017

THE MANAGEMENT OF TMJ ANKYLOSIS A COMPLETE REVIEW.

Ramesh K, Khadar Vali Shaik, Haripriya Chari, Ashok Kumar, Kiran Kumar

Abstract :

Temporomandibular joint (TMJ) ankylosis is one of the most serious disabling condition; Impairment of speech, difficulty in mastication, poor oral hygiene; rampant caries,disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability This paper describes the management protocol of TMJ ankylosis and its review . The major objectives of surgical treatment in patients with temporomandibular joint ankylosis include the meticulous and radical removal of the ankylotic bone and reconstruction and restoration of the physiologic functions of the jaws. Kaban’s operative protocol for unilateral and bilateral TMJ ankylosis entailed resection of ankylotic mass, ipsilateral and/or contralateral coronoidectomy, interpositional tissue transfer to the TMJ with temporalis myofascial flap, and early mobilization and aggressive physiotherapy. Common complications that encounter includes deviation of the mandible to the effected side , telescoping of the mandible following gap arthroplasty leading to occlusal discrepancies & anterior openbite , temporary facial nerve weakness. Deviation of the mandible & occlusal disturbances can be treated by early placement of arch bars & mouth opening exercises. Improvement can be noticed in 3 to 4 months. The post–operative physiotherapy plays an extremely important role in preventing re–ankylosis & maintaining adequate mouth opening. A careful surgical technique and subsequent meticulous long–term physiotherapy are both essential to achieve a satisfactory result.