The Comparison between Three Surgical Techniques in Temporomandibular Joint Ankylosis

Introduction & Temporomandibular joint (TMJ) ankylosis can lead to the restriction of mouth opening, poor mouth cavity hygiene, dental abscess and face deformity. Despite several researches concerning the TMJ arthroplasty techniques, there are controversies about the best surgical technique in TMJ ankylosis repair. In this study, we report the comparison of three surgical techniques - Costo Chondral Graft (CCG), Temporal Fascia Graft and Silicon Prosthesis Graft - in TMJ arthroplasty. In 10-year duration (1997-2007), thirty four patients with TMJ ankylosis were admitted in Fatima Hospital, and they all were included in this study. They were operated with Inter positional Gap Arthroplasty. Ten patients were operated with CCG surgical techniques, 10 patients with Silicon Prosthesis Graft and 14 patients with Temporal Fascia Graft. Results of these surgical techniques were compared after at least 7-month post operation follow up. In this study, the most frequent cause of TMJ ankylosis was trauma (52.9%). 19 patients had bilateral surgical operations that resulted in 12 unsuccessful (63.2%) and 7 successful cases (36.8%). Overall, 29 patients used post operation physiotherapy and that resulted in 12 unsuccessful (41.4%) and 17 successful cases (58.6%). In TMJ arthroplasty, unilateral surgical operations were significantly more successful (P=0.03), whereas the results in these three surgical operation techniques were the same. In addition, the use of post operation physiotherapy did not show significant statistical differences in the results.