Abstract
Introduction: The management of TMJ ankylosis poses a great challenge due to high recurrence rate. A no. of inter positional materials let it be alloplastic or autogenous tissues have been used. The adaptive centre is preferred rather than growth centre as given in literature. SCG is presumed to be more suitable inter positional material after TMJ arthroplasty.
The Aim of this article is to report that SCG is more similar developmentally, morphologically, anatomically and show less recurrence that CCG.
Material and Method: This prospective study included 15 patients of unilateral TMJ ankylosis. Age of patients 8 – 18 years, duration of ankylosis presented from 5 to 10 years. 12 patients had history of trauma in childhood, 3 patients had ear infection. After diagnosis patient were divided in 2 groups Group Asternoclavicular graft, Group B – Costochondral graft.
Results: In group A – Mouth opening at 6 months was 35.4 mm. Significant growth of mandible as compared with group B. Follow up at 5 years and there was no recurrence or any reunion was reported. In group B – 2 Patients had recurrence and reported after 3 years.
Conclusion: Reconstruction of TMJ with sternoclavicular graft was more effective with regard in interincisal mouth opening, recurrence , growth of mandible and articular function.
References
- Chossegros C, Guyot L, Cheynet F, Blanc JL, Gola R, Bourezak Z, Conrath J. Comparison of different materials for interposition arthroplasty in treatment of temporomandibular joint ankylosis surgery: long-term follow-up in 25 cases. Br J Oral MaxillofacSurg 1997;35:157-60.
- Manganello-Souza LC, Mariani PB. Temporomandibular joint ankylosis: report of 14 cases. Int J Oral MaxillofacSurg 2003; 32:24-9.
- Toyama M, Kurita K, Koga K, Ogi N. Ankylosis of the temporomandibular joint developing shortly after multiple facial fractures. Int J Oral MaxillofacSurg 2003; 32:360-2.
- Kazanzian VH. Temporomandibular joint ankylosis. Am J Surg 1955: 90: 905.
- Chidzonga MM. Temporomandibular joint ankylosis: review of thirty-two cases. Br J Oral MaxillofacSurg 1999;37:123-6.
- Roychoudhury A, Parkash H, Trikha A. Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 1999 Feb;87(2):166-9.
- Kaban LB, Perrott DH, Fisher K. A protocol for management of temporoman- dibular joint ankylosis. J Oral Maxillofac Surg. 1990 Nov;48(11):1145-51.
- Erdem E, Alkan A. The use of acrylic marbles for interposition arthroplasty in the treatment of temporomandibular joint ankylosis: follow-up of 47 cases. Int J Oral Maxillofac Surg. 2001 Feb;30(1):32-6.
- Smith JA, Sandler NA, OkaziWH, Braun TW. Subjective and objective assessment of the temporal myofacial flap in previously operated temporomandibu- lar joints. J Oral MaxillofacSurg 1999: 57: 1058–1065.
- Su gwan K. Treatment of temporoman- dibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral MaxillofacSurg 2001: 30: 189–193.
- Pogrel MA, KabanLB. The role of a temporalis fascia and muscle flap in temporomandibular joint surgery. J Oral MaxillofacSurg 1990: 48: 14–19.
- Karaca C, BaructuA, Menderes A. Inverted, T-shaped silicone implant for the treatment of temporomandibular joint ankylosis. J CraniofacSurg 1998: 9: 539–542.
- Salins PC. New perspectives in the man- agement of craniomandibularankylosis. Int J Oral MaxillofacSurg 2000: 29: 337–340.
- Dechamplain RW, Gallagher CS, Marshall ET. Autopolymerizing silastic for interpositional arthroplasty. J Oral MaxillofacSurg 1988: 46: 522–525.
- Kalamchi S, WalkerRV. Silastic implant as a part of temporomandibular joint arthroplasty. Evaluation of its effi- cacy. Br J Oral MaxillofacSurg 1987: 25: 227–236.
- Rowe NL. Ankylosis of the temporomandibular joint. Parts 1, 2 and 3. J R Co11 Surg Edinb 1982;27:67-79,167-173
- Ko EW, Huang CS, Chen YR. Temporomandibular joint recon- struction in children using costochondral grafts. J Oral Maxillofac Surg. 1999;57:789-98.
- Lata J, Kapila BK. Overgrowth of a costochondral graft in tem- poroman-dibular joint reconstructive surgery: an uncommon compli- cation. Quintessence Int. 2000;31:412-4.
- Siavosh S, Ali M. Overgrowth of a costochondral graft in a case of temporomandibular joint ankylosis. J Craniofac Surg. 2007;18:1488-91.
- Perrott DH, Umeda H, Kaban LB. Costochondral graft construc- tion/reconstruction of the ramus/condyle unit: long-term follow-up. Int J Oral Maxillofac Surg. 1994;23:321-8.
- Snyder CC, Levine GA, Dingmen DL. Trial of a sternoclavicular whole joint graft as a substitute for the temporomandibular joint. PlastReconstrsurg 1971;48:447-452
- Ellis E III, Carlson DS. Histologic comparision of costochondral, sternoclavicular and temporomendibular joints during growth in maccacamulatta. J Oral MaxillofacSurg 1986;44:312-321
Corresponding Author
Nahida Dar
Oral and Maxillofacial Surgeon, SGT Dental College
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.195
