Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

Min Woo Park; Mi Young Eo; Bo Yeon Seo; Truc Thi Hoang Nguyen; Soung Min Kim

Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

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Type: Academic journal

Author: Min Woo Park Mi Young Eo Bo Yeon Seo Truc Thi Hoang Nguyen Soung Min Kim

Journal: Korean Association of Maxillofacial Plastic and Reconstructive Surgeons Maxillofacial Plastic Reconstructive Surgery Maxillofacial Plastic Reconstructive Surgery 제41권 제4호 KCI Accredited Journals

Published: 2019.1

Pages: 1 - 10 (10page)

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Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients

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BackgroundTemporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis. MethodsA total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period. ResultsAll patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS’s guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery. ConclusionsComplete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.

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Kaban LB / 2009 / A protocol for management of temporomandibular joint ankylosis in children / J Oral Maxillofac Surg 67:1966~1978

Helenius LM / 2006 / Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases / Int J Oral Maxillofac Surg 35:983~989

Helenius LM / 2005 / Clinical and radiographic findings of the temporomandibular joint in patients with various rheumatic diseases. A case-control study / Oral Surg Oral Med Oral Pathol Oral Radiol Endod 99:455~463

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