TMJ Ankylosis

TMJ Ankylosis | Stiff Jaw | Lock Jaw Correction

The temporomandibulat Joint enables movements of the mandible (lower jaw) to aid functions like mastication and speech. Sometimes, one or both the joints may fuse. This is most commonly seen in cases where there has been prior trauma or injury to the joint. Due to fusion of the bones, jaw movement and mouth opening gets severely restricted and extremely painful. Surgery must be done to restore joint movement.

Dr. Balaji is the first Maxillofacial Surgeon in India to be awarded a PhD in Temporomandibular Joint Surgery. He excels at gap arthroplasty with Temporalis muscle interpositioning surgery for the treatment of TMJ ankylosis. In this, the fused bone mass is removed and a part of the temporalis muscle from in front of the ear is taken and repositioned in the TMJ space.

Gap arthroplasty along with bone graft from the rib (costochondral graft) may be performed in some cases to reconstruct the temporomandibular joint with ankylosis.

Dr. Balaji is a pioneer in advocating the recent advancement is Maxillofacial Surgery-Distraction Osteogenesis as a means of temporomandibular joint reconstruction. He has successfully used this technique along with gap arthroplasty in reconstructing TMJ and correcting facial asymmetry in innumerable patients afflicted with TMJ ankylosis.

Case 1

Gap arthroplasty with costochondral graft

TMJ ankylosis causing stunted growth of lower jaw

TMJ ankylosis causing stunted growth of lower jaw

Preoperative view showing decreased mouth opening

Preoperative view showing decreased mouth opening

3D CT showing TMJ joint space obliteration on both sides with fused bony mass-TMJ ankylosis

3D CT showing TMJ joint space obliteration on both sides with fused bony mass

3D CT showing TMJ joint space obliteration on both sides with fused bony mass-TMJ ankylosis

3D CT showing TMJ joint space obliteration on both sides with fused bony mass

Harvested rib grafts (costochondral grafts)

Harvested rib grafts (costochondral grafts)

Gap arthroplasty surgery - TM joint reconstruction with rib graft secured to mandible with titanium screws

TM joint reconstruction with rib graft secured to mandible with titanium screws

TM joint reconstruction with rib graft secured to mandible with titanium screws

TM joint reconstruction with rib graft secured to mandible with titanium screws

Postoperative view showing symmetric face with prominent chin

Postoperative view showing symmetric face with prominent chin

Increased mouth opening a few days after surgery

Increased mouth opening a few days after surgery

Case 2

GAP ARTHROPLASTY WITH COSTOCHONDRAL GRAFT

Retruded chin and poor lower jaw growth due to TMJ ankylosis

Retruded chin and poor lower jaw growth due to TMJ ankylosis

Profile view showing lower jaw defect

Profile view showing lower jaw defect

Costochondral grafts (rib grafts ) harvested

Costochondral grafts (rib grafts ) harvested

Gap arthroplasty surgery with costochongral graft

Gap arthroplasty surgery with costochongral graft

Gap arthroplasty surgery with costochongral graft

Gap arthroplasty surgery with costochongral graft

Improved facial appearance and chin made more prominent following surgery

Improved facial appearance and chin made more prominent following surgery

Enhanced facial profile following surgery

Enhanced facial profile following surgery

Case 3

Unilateral ankylosis - Gap arthroplasty with costochondral graft

Facial asymmetry due to unilateral TMJ ankylosis

Facial asymmetry due to unilateral TMJ ankylosis

Harvested costochondral graft

Harvested costochondral graft

TMJ reconstruction surgery

TMJ reconstruction surgery

Face asymmetry corrected following surgery

Face asymmetry corrected following surgery

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