Management of temporomandibular ankylosis with temporal fascia inter-positional arthroplasty and distraction osteogenesis: report of 30 cases.

UNLABELLED Interposition arthroplasty in cases of temporomandibular ankylosis provides satisfactory postoperative mouth opening but correction of the associated facial deformity demands proper attention. PURPOSE To evaluate the use of distraction osteogenesis for correction of facial deformity caused by temporomandibular ankylosis. MATERIAL This study was conducted in 30 children (age 6-22 , median 12 years), with mandibular deformity as a result of temporomandibular ankylosis. The mean duration of ankylosis was 6.37(2.97) years, range 2-14 years. Extra oral or intraoral distractors were placed using pins or screws and distraction of mandibular body was achieved. Post operatively these patients were subjected to vigorous physiotherapy using wooden spatulas or jaw exerciser. RESULTS Pre-operative inter-incisal mouth opening ranged from 0-6 mm, mean 3.33(1.81) mm where as post-operative mean mouth opening was 39.40(2.36) mm, range 34-44 mm. All the patients showed improved facial profile and symmetry with maintained, satisfactory mouth opening on follow up which ranged from 2 to 5 years. These patients were later subjected to orthodontic treatment to achieve a good intercuspal relationship and a stable occlusion. CONCLUSION Distraction osteogenesis provides excellent cosmetic results in the patients of temporomandibular ankylosis and should be preferred as a method of correction for mandibular deformities.