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Case Reports
. 2011:2011:187580.
doi: 10.1155/2011/187580. Epub 2011 Sep 20.

TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement-A Case Report

Pavankumar Janardan Vibhute  1 , Nitin Bhola, Rajiv M Borle
Affiliations
Case Reports

TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement-A Case Report

Pavankumar Janardan Vibhute et al. Case Rep Dent. 2011.

Abstract

This report describes the multidisciplinary phasewise treatment of a 20-year-old female patient having unilateral right TMJ bony (true) ankylosis whose mouth opening was restricted to 2 mm and mandibular retrognathism; additionally, she was also suffering from speech problems, snoring, difficulty in breathing, and low level of self-esteem and self-confidence. Bilateral gap arthroplasty and temporalis myofascial graft interpositioning through preauricular approach were done in surgical phase followed by the aggressive jaw physiotherapy in postsurgical period. Oral prophylaxis and restorations were followed by the fixed orthodontic therapy to resolve bimaxillary protrusion. Advancement sliding genioplasty was performed to enhance the chin button. Speech therapy and psychological counseling were also performed from time to time to boost up the self-esteem and self-confidence. At the end of treatment, facial esthetics was improved considerably and patient got over the impact of disfigurement, impaired functions, and psychosocial stigma. Rationale to use the multidisciplinary team approach in treatment of such cases is discussed.

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Figures

Figure 1
Figure 1
(a)–(f) pretreatment, before TMJ ankylosis surgery. Mouth opening restricted to 3 mm only.
Figure 2
Figure 2
(a)–(h) gap arthroplasty and temporalis graft interpositioning through preauricular approach.
Figure 3
Figure 3
3 months after surgery mouth opening increased up to 4 cm.
Figure 4
Figure 4
(a)–(d) facial photographs at commencing of orthodontic treatment for bimaxillary protrusion and before genioplasty.
Figure 5
Figure 5
(a)-(b) radiographs after completion of orthodontic treatment and before genioplasty.
Figure 6
Figure 6
(a)–(d): after completion of orthodontic treatment and 7 mm advancement genioplasty, facial esthetics was improved considerably.
Figure 7
Figure 7
(a) Postgenioplasty cephalogram, (b) pre-and posttreatment superimposition.
See this image and copyright information in PMC

References

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