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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 2009 January-February;58(1-2):35-42
language: English, Italian
Temporomandibular joint bilateral post-traumatic ankylosis: a report of a case treated with interpositional arthroplasty
Manfredini D., Bucci M. B., Guarda-Nardini L.
Department of Maxillo-Facial Surgery University of Padua, Padua, Italy
Ankylosis of the temporomandibular joint (TMJ) is a severe disorder which leads to jaw function impairment and restricted mouth opening. The surgical approach to TMJ ankylosis can be performed according to different techniques. The present paper is a report of a bilateral post-traumatic case of TMJ ankylosis. The patient suffered bilateral condylar fractures as a consequence of a road accident and showed a limited mouth opening (22 mm) along with dental occlusion abnormalities. Conservative treatments were uneffective to improve jaw impairment, so a computerized tomography was requested for surgical treatment planning. Both temporomandibular joints showed severe ankylosis with a bone fragment located medially to the condyle. An arthroplasty with the interposition of a combined flap (temporalis muscle, fascia, periosteum) was performed. The post-treatment course was uneventful, and the patient has undergone physiatric rehabilitation immediately after the intervention. At the 5-years follow-up mouth opening was 46 mm. TMJ arthroplasty with the interposition of autogenous material is an effective technique to restore jaw function and to prevent recurrencies in cases of ankylosis.