Overview
Ankylosis may be defined as the fusion of joint surfaces. TMJ ankylosis is a rare disorder due to the fusion of the mandibular condyle at the cranial base. Trauma, systemic diseases, or infections mainly cause it. It is divided into fibrous and bony types:
- Fibrous—the result of chronic inflammation (rheumatoid arthritis) or disuse—mostly associated with disk displacements (as a result of traumatic injuries) and involves the actual joint.
- Bony—partial ossification of the joint capsule and extracurricular conditions (such as enlargement of the coronoid process) or complete fusion of the mandible to the temporal bone.
Symptoms
Pain; loss of range of motion; deformed facial aesthetics; asymmetrical jaw line; acute compromise of the airway, resulting in physical and psychological disability.
Diagnosis
Patient clinical history:
- Past history of any disease or condition that could lead to current state; history of trauma; usually bilateral but can be unilateral.
Radiographs:
- Imaging shows loss of normal joint architecture: identifies condylar deformity and either narrowing or irregularity of joint space or obliteration of the normal bony morphology.
Treatment
Arthrotomy with disk reconstruction, costalchondral graft, partial or total joint replacement.
Prognosis
a-maintain maximum ramal height
b-insertion of interpostional material to avoid fusion of joint anatomical components.
c-initiate long-term post-surgical physical therapy.