GAP ARTHROPLASTY COMBINED WITH PHYSICAL THERAPY IN THE TREATMENT OF TEMPOROMANDIBULAR-JOINT ANKYLOSIS

To describe a simple and efficacious surgical technique in the treatme nt of TMJ ankylosis, namely gap arthroplasty and to emphasize the role of physical therapy after surgery. Design: Clinical documentation, op eration notes and post-operative follow up of TMJ ankylosis cases whic h were operated by using the gap arthroplasty without interposition of any materials. Setting: Oral and maxillofacial surgery division of th e College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Su bject: Ten cases of TMJ ankylosis operated by using gap arthroplasty a nd without interposition of any materials. Results: In all cases, gap arthroplasty was used without interposition of any materials. Physical therapy began from the second post-operative day after intraoperative initial manipulation of mandible following joint release. Within 8 we eks of the operation, mandibular range of motion improved remarkably a nd an average 40-50 mm interincisal distance achieved. There were no i ntraoperative or postoperative complications and the mouth-opening has remained, without tendency to relapse, for the past four years. Concl usions: Gap arthroplasty is a simple, pet efficacious surgical procedu re for the release of the ankylosis of temporomandibular joint. It ass essed The preservation of some remnants of the condylar head and maint ained the functional matrix. Nevertheless, it does not by itself bring about a satisfactory result rind the importance in post-operative man agement is the opening exercise of the mandible for at least 6 months after surgery.