Abhay Datarkar, Subodh Purohit*, Amit Bhawalkar, Surendra Dawre and Arwa Pardiwala
Department of Oral and Maxillofacial Surgery, Government Dental College & Hospital, Government Medical
College Campus, India
Purpose: To evaluate the sequential treatment of patients with temporomandibular joint ankylosis and secondary deformities by distraction osteogenesis and subsequent arthroplasty or orthognathic surgery.
Method: This is a Prospective Institutional based clinical study in which 15 patients with age ranging from 18 to 28 years (mean = 22.1 years) diagnosed with unilateral temporomandibular joint ankylosis were included. All the 15 patients were first treated with distraction osteogenesis followed by interpositional arthroplasty of TMJ. Out of these 15 patients, 11 underwent facial correction
Orthognathic surgery. Patients were evaluated for difference in airway after completion of treatment using cephalometric analysis, Increase in maximum interincisal opening, Difference in weight of patient and a questioner based subjective evaluation of improvement in facial esthetics, symptoms of sleep apnea and betterment in quality of life of patient.
Results: Sequence of early Distraction osteogenesis, followed by Interpositional Arthroplasty and final facial correction using corrective facial surgery is useful in treatment of adult temporomandibular joint ankyloses. Improvement was seen in maximum interincisal opening, stable occlusion and reduction in sleep apnea as well as increase in upper airway space was noticed. Patients were kept under a long follow-up, ranging from 6 to 50 months with an average of 24.3 months. Relapse was noticed in 1 patient.
Conclusion: This study reveals that distraction osteogenesis followed by arthroplasty and corrective orthognathic surgery when required can provide good results in temporomandibular joint ankylosis patients with good facial features, stable occlusion, adequate mouth opening and reduction in obstructive sleep apnea syndrome.
Distraction; TMJ ankylosis; Sleep apnea; Orthognathic Surgery
Datarkar A, Purohit S, Bhawalkar A, Dawre S, Pardiwala A. An Algorithm for Facial Asymmetry Correction in Adult
TMJ Ankylosis Patients - A Clinical Study. Am J Otolaryngol Head NeckSurg. 2021; 4(7): 1147..