Efficacy of temporomandibular joint ankylosis surgical treatment

Abstract

Purpose: The purpose of the present study was to answer the following clinical question: of the patients with temporomandibular joint ankylosis, do those treated with ankylosis resection and ramus-condyle unit reconstruction with a prosthetic total joint (total joint replacement [TJR]) have improved jaw function and decreased pain compared with those treated with ankylosis resection and interpositional arthroplasty (IA)?

Materials and methods: Using a retrospective study design, the investigators enrolled a sample derived from the population of patients presenting to the Massachusetts General Hospital (Boston, MA) and the University of Oslo Faculty of Dentistry from 1998 to 2008 for the evaluation and management of temporomandibular joint ankylosis. The primary predictor variable was treatment (ie, TJR or IA). The outcome variables were the maximal interincisal opening and pain. Data analyses were performed using bivariate and multiple regression methods.

Results: The final study sample included 36 subjects with a mean age of 40 +/- 13.1 years, and 25 were women (69%). Of the 36 patients, 14 (39%) and 22 (61%) were in the TJR and IA groups, respectively. The changes in the maximal interincisal opening in the TJR and IA groups were 9.4 +/- 6.7 and 18 +/- 9.7 mm (P = .02). After adjusting for institutional location, number of previous operations, laterality (unilateral versus bilateral operation), age, and etiology, the difference in the maximal interincisal opening between the 2 treatment groups was not significant (P = .06). The changes between preoperative and postoperative pain scores were insignificant between the groups (P = .16).

Conclusion: Ankylosis resection and ramus-condyle unit reconstruction with a prosthetic total joint and IA produced comparable outcomes in terms of mandibular range of motion and pain.