Surgical treatment of temporomandibular joint ankylosis: follow-up of 15 cases and literature review.

INTRODUCTION Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. PURPOSE To report 15 cases treated by either gap arthroplasty, or the articular reconstruction technique using costochondral grafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literature review. METHODS The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patients submitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre-and post-operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate and presence of facial nerve paralysis. RESULTS The mean maximal incisal opening in the preoperative period was 8.71 + 6.97 mm and in the postoperative period it was 28.50 + 8.10 mm, the recurrence rate was 20% (n=3), and always occurred in ankylosis type IV. CONCLUSION The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.