Functional restoration by gap arthroplasty in temporomandibular joint ankylosis - A report of 50 cases

Objective. The purpose of this study was to determine the cause of temporom andibular ankylosis and the long-term results of gap arthroplasty with coro noidectomy followed by immediate postoperative jaw exercises as a treatment of the condition. Study design. This retrospective study evaluated the cause of temporomandib ular joint ankylosis and the 36-month postoperative results of gap arthropl asty in 50 patients (62 joints). The patients were divided into 2 groups; g roup I (aged 0-12 years) consisted of 29 cases (24 unilateral and 5 bilater al; 34 joints); group II (aged 13-30 years) consisted of 21 cases [14 unila teral and 7 bilateral; 28 joints). A postoperative jaw opening exercise reg imen was followed. Descriptive statistics, the Wilcoxon signed rank test, a nd rank sum 2-sample (Mann-Whitney) tests were applied. Result. Trauma to the temporomandibular joint was documented as a major eti ologic factor in 86% of cases. The 36-month postoperative mean maximal inci sal opening was 30.62 mm (+/- 6.25 mm] for group I and 30.14 mm (+/- 3.9 mm ) for group II. The P value in each group was highly significant for the Wi lcoxon signed rank test; the Mann-Whitney test showed no difference between the groups, indicating that both groups had done well. The recurrence rate was 2%. Conclusion. Trauma is the major cause of temporomandibular joint ankylosis in India. The long-term functional results of gap arthroplasty are satisfac tory and comparable to those obtained through use of other treatments. Post operative exercises play a crucial role in lasting success.