USE OF SILASTIC AS INTERPOSITIONAL MATERIAL IN THE MANAGEMENT OF UNILATERAL TEMPOROMANDIBULAR JOINT ANKYLOSIS

Muhammad Usman Akhtar, Iram Abbas, Adnan Ali Shah

Abstract


Background: Ankylosis is a very common condition developed mainly after damage to
mandibular condyles or temporomandibular joint (TMJ) at a growing age. Different autogenous
and alloplastic interpositional materials have been attempted after the resection of the ankylotic
bone to achieve desirable results. This condition is relatively common in Pakistan. We treated
TMJ ankylosis with alloplastic medical grade silicone “silastic” interpositional arthroplasty. Eight
joints accompanied ipsilateral or contralateral coronoidectomy to achieve desirable results.
Method: All patients were presented at Punjab Dental Hospital Lahore. Sixty-one joints with
unilateral TMJ ankylosis were underwent surgery after careful examination and final radiographic
confirmation. The preoperative CT scan was also performed in few patients. Results: The
postoperative measurements of the interincisal opening with lateral and protrusive jaw movements
were criteria for success of surgery. The lateral and protrusive jaw movements were assessed as
excellent, good and poor. Less than 25 mm interincisal opening was considered as poor jaw
opening. Conclusion: The overall success rate was 98.4 % with 84 % desirable interincisal jaw
opening. Less than 5 % patients were observed with poor jaw opening. The immediate late
complications were transient and were included oedema, weakness of a branch of the facial nerve
on the operated side. Two implants were infected along with one wire in the first month of surgery
and were removed under local anaesthesia without further complication.
Key words: Ankylosis, silastic, interpositional material, arthroplasty, coronoidectomy and jaw
movements.

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