SURGICAL-MANAGEMENT OF TEMPOROMANDIBULAR-JOINT ANKYLOSIS TYPE-III BY RETAINING THE DISPLACED CONDYLE AND DISC

Purpose: This article proposes a hypothesis regarding the value of sav ing the fractured condyle and disc in their displaced position in anky losis type III for optimal temporomandibular joint (TMJ) function and growth, and describes four cases treated in this manner. Patients and Methods: Four patients (three females and one male, 9 to 48 years old) with TMJ ankylosis type III of 3 to 8 years' duration, a maximal mout h opening of 15 to 19 mm, and severely limited lateral and protrusive movements were treated. The ankylosed sites were resected, leaving the displaced condyle and disc in their medial position. Results: Fifteen to 60 months after surgery, the patients had a maximal mouth opening of 44 to 50 mm, as well as better contralateral and protrusive movemen ts. In addition, two young patients (9 and 11 years old) showed an imp roved facial symmetry. Conclusions: Treatment of patients with type II I TMJ ankylosis should involve retention rather than removal of the di splaced condyle and disc. The condyle and disc are left untouched in t heir precarious medial position so as to provide normal function and g rowth.