Coronoid process and residual ankylotic mass as an autograft in the management of ankylosis of the temporomandibular joint in young adolescent patients: a retrospective clinical investigation

• Published in: British journal of oral & maxillofacial surgery Vol. 54; no. 3; pp. 280 - 285
• Main Authors: Bansal, Vishal, Mowar, Apoorva, Dubey, Prajesh, Bhatnagar, Aditi, Bansal, Avi
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.04.2016
• Subjects: Adolescent; Ankylosis - surgery; Ankylotic bone; Arthroplasty; Autografts - surgery; Bite force gauge; Coronoid process mandible; Costochondral graft; Dentistry; Humans; Retrospective Studies; Sternoclavicular graft; Surgery; Temporomandibular ankylosis; Temporomandibular Joint - surgery; Temporomandibular Joint Disorders - surgery; Temporomandibular reconstruction; Ankylotic bone; Bite force gauge; Costochondral graft; Temporomandibular reconstruction; Sternoclavicular graft; Coronoid process mandible; Temporomandibular ankylosis
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2016.01.012

Abstract The aim of this non-randomised investigation was to assess the feasibility of using autogenous grafts (such as coronoid process and the resected ankylotic mass) in reconstruction of the condyle after gap arthroplasty for ankylosis of the temporomandibular joint (TMJ). Sixteen patients (23 joints) operated on between 2007 and 2009 were studied and postoperative measurements of maximum interincisal opening, bite force, range of movement, and infection were recorded. After a mean (SD) follow up of 55 (2.25) months mouth opening improved from 3 (3.84) mm to 33 (1.66) mm in patients treated with coronoid graft, while in patients treated with an ankylotic mass after a mean (SD) follow up of 58 (1.58) months it increased from 4 (2.64) mm to 26 (8.04) mm. Bite force six months postoperatively ranged from 18.25 kg/cm2 – 27.5 kg/cm2 after reconstruction with the coronoid process and 18.5 kg/cm2 – 23.25 kg/cm2 after reconstruction with the ankylotic mass. One patient developed reankylosis postoperatively and another developed infection, in both of which the ankylotic mass had been used. Both were managed successfully. Both the ankylotic mass and the coronoid process gave satisfactory results and seem to be options for reconstruction. However, the coronoid process graft was better than residual ankylotic mass in terms of masticatory efficiency, bite force, and range of movement.