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VOLUME 12 , ISSUE 4 ( July-August, 2011 ) > List of Articles

RESEARCH ARTICLE

Modified Gap Arthroplasty and Myrhaug's Incision as a Treatment Option in Management of Temporomandibular Joint Ankylosis: A Study of 10 Cases

Shalini Gupta, Arvind Agarwal, Brijesh Ruparelia, Ajay Kubawat, Sandeep Patel

Citation Information : Gupta S, Agarwal A, Ruparelia B, Kubawat A, Patel S. Modified Gap Arthroplasty and Myrhaug's Incision as a Treatment Option in Management of Temporomandibular Joint Ankylosis: A Study of 10 Cases. J Contemp Dent Pract 2011; 12 (4):295-300.

DOI: 10.5005/jp-journals-10024-1049

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Purpose of the study

The purpose of this study was to evaluate effectiveness of modified gap arthroplasty procedure and modified Myrhaug's preauricular incision for treating bony temporomandibular joint (TMJ) ankylosis.

Materials and methods

A total of 10 cases were included in the study with Sawhney's type III and IV TMJ ankylosis. Study consisted of 6 males and 4 females. Three cases were treated for bilateral ankylosis and 7 were treated for unilateral ankylosis. All the patients were treated with modified gap arthroplasty and modified Myrhaug's incision was used. In this modification, osteotomy cuts were modified in such a way that coronoid process was also removed simultaneously along with the osteotomized ankylosed mass in one piece.

Results

All the patients were followed up for 5 years and none of them presented with recurrence. Two patients had transient paresis to zygomatic and temporal branch of facial nerve and none had permanent damage to the nerve. Seven patients had mouth opening more than 25 mm (p) when followed for 5 years. Anterior open bite was seen in 4 patients and deviation of the jaw on ipsilateral side was noted in 2 patients.

Conclusion

Modified gap arthroplasty gave successful results in the follow-up period and eliminated the need of separate coronoidectomy. Use of modified Myrhaug's preauricular approach, provided excellent visibility particularly of the elongated coronoid process, minimized bleeding, prevented damage to the vital anatomical structures surrounding the joint and gave acceptable cosmetic results.

Clinical significance

The modified incision has been found to be reducing intra- and postoperative morbidity as well as provides excellent accessibility. The modified osteotomy technique eliminated the need for separate coronoidectomy thus significantly reducing the operating time.

How to cite this article

Agarwal A, Ruparelia B, Kubawat A, Patel S, Gupta S. Modified Gap Arthroplasty and Myrhaug's Incision as a Treatment Option in Management of Temporomandibular Joint Ankylosis: A Study of 10 Cases. J Contemp Dent Pract 2011;12(4):295-300.


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  1. Preservation of disc for treatment of traumatic temporomandibular joint ankylosis. J Oral Maxillofac Surg Jul 2005;63(7):897-902.
  2. A protocol for management of temporomandibular joint ankylosis. J Oral Maxillofac Surg 1990;48:1145-51.
  3. Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction. J Craniofac Surg 2002;13:401-09.
  4. Temporomandibular joint ankylosis: Report of 14 cases. Int J Oral Maxillofac Surg 2003; 32:24-29.
  5. Treatment of temporomandibular joint ankylosis by gap arthroplasty. Med Oral patol Oral Cir Bucal 2006;11:E 66-69.
  6. Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg Jun 2001;30(3):189-93.
  7. Treatment of temporomandibular joint ankylosis by a modified fossa prosthesis. J Craniomaxillofac Surg Aug 2004;32(4):236-42.
  8. Auricular cartilage graft interposition after temporomandibular joint ankylosis surgery in children. J Oral Maxillofac Surg Sep 2002;60(9):985-87.
  9. Interpositional material to prevent reankylosis. Journal of Craniofacial Surgery Jan 2002;13(1):59-67.
  10. Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: A report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod Feb 1999;87(2):166-69.
  11. The use of acrylic marbles for interposition arthroplasty in the treatment of temporomandibular joint ankylosis: Follow-up of 47 cases. Int J Oral Maxillofac Surg Feb 2001;30(1):32-36.
  12. Bony ankylosis of the temporomandibular joint: Follow-up of 70 patients treated with arthroplasty and acrylic Spacer interposition. Plast Reconstr Surg 1986;77:29-38.
  13. Ankylosis of temporomandibular joint in children. Journal of Indian Society of Pedodontics and Preventive Dentistry, Case Report 2009;27(2):116-20.
  14. Treatment of temporomandibular joint ankylosis by gap arthroplasty. Med Oral Patol Oral Cir Bucal Jan 2006;11(1):E66-69.
  15. Comparison of gap arthroplasty and interpositional Gap arthroplasty on the temporomandibular joint ankylosis. Acta Medica Iranica 2006;44(6):391-94.
  16. The effect of gap arthroplasty on temporomandibular joint ankylosis: An experimental study. Int J Oral Maxillofac Surg Oct 2001;30(5):431-37.
  17. A retrospective study of the costochondral graft in TMJ reconstruction. Int J Oral Maxillofac Surg Dec 2003;32(6):606-09.
  18. The use of autogenous tissues for temporomandibular joint reconstruction. J Oral Maxillofac Surg Jan 2000;58(1):63-69.
  19. Total prosthetic replacement of the TMJ: Experience with two systems 1988-1997. Br J Oral Maxillofac Surg Aug 2000;38(4):360-69.
  20. Role of computed tomography in TM joint problems. Ind J of Oral and Maxillofacial Surg 1991;6:3.
  21. Imaging of temporomandibular joint ankylosis. A new radiographic classication. Dentomaxillofacial Radiology 2002;31:19-23.
  22. Treatment of temporomandibular joint ankylosis by a modified fossa prosthesis. J Craniomaxillofac Surg 2004; 32:236-42.
  23. Intraoral mandibular distraction osteogenesis in facial asymmetry patients with unilateral temporomandibular joint bony ankylosis. Int J Oral Maxillofac Surg 2002;31: 544-48.
  24. Int J Oral Maxillofac Surg 2003;32: 353-59.
  25. The deep subfascial approach to the temporomandibular joint. J Oral Maxillofac Surg Sep 2004;62(9):1097-1102.
  26. Ankylosis of the temporomandibular joint. Follow-up of thirteen patients. Oral Surg Oral Med Oral Pathol Jul 1992;74(1):7-14.
  27. Facial nerve function following temporomandibular joint surgery using the preauricular approach. J Oral Maxillofac Surg Oct 1992;50(10):1048-51.
  28. Treatment of TMJ ankylosis in Jordanian children: A comparison of two surgical techniques. J Craniomaxillofac Surg 2005;33:30-36.
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