Treating tmj ankylosis: a nepal experience

Introduction: Although temporomandibuular joint (TMJ) ankylosis is one of most commonly encountered condition it is also the most overlooked and under managed conditions in dental practice. TMJ forms the cornerstone of cranio-facial integrity and hence its ankylosis adversely affects the growth and development of the jaws and occlusion. Impairment of speech, difficulty in mastication, poor oral hygiene, rampant caries and acute compromise of the airway are the consequences of ankylosed TMJ. Aim: The aim of this article is to present review of cases of TMJ ankylosis seen in Nepal. The various management strategies and their applications are discussed herewith. Materials and methods: The authors present here the surgeries of TMJ ankylosis carried out at different hospitals of Nepal during a period of 7 years (2003-2010) with a mean follow up period 5 years.The total numbers of patients were 20 and the total numbers of joints operated were 28. Al kayat Brahmley incison was used and aggressive post-operative mouth opening exercises for minimum of 6 months were done in all the cases. Results: Out of the 28 joints involved: 20 were bony, 5 fibro-osseous and 3 were fibrous. The Al kayat Brahmley incison was used in all the cases. Different surgeries done were involving temporalis fascia, temporalis myofascia, silastic block and dermis. The mouth opening was increased in all cases, post operative complications were noticed in seven cases and no case of recurrence was reported. Conclusion: The authors have shared their experiences of TMJ surgeries and tried to create awareness of the clinical signs and symptoms of TMJ ankylosis, to allow early diagnosis and treatment.