• Muhammad Usman Akhtar
  • Iram Abbas
  • Adnan Ali Shah


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


Walker RV. Arthroplasty of the ankylosis temporomandibular

joint. AM Surg. 1958; 24: (6).

Gallagher MD, Wolford LM. Comparison of silastic and proplast

implants in the TMJ after condylectomy for osteoarthritis. J Oral

Max Fac Surgery 1982; 40: 627-630.3. Akhtar MU, Ali K, Arain A, Mirza YB, Chaudhry Z.

Management of temporomandibular joint ankylosis: a long termcomparative study. J Coll Physicians Surg Pak 2001;2(11):84-7.4. Swanson AB. Finger joint replacement by silicone rubber

implants and its concept of implant fixation by encapsulation.

Ann Rheum Dis 1969; 28: 47-55.

Kreutziger KL, Mahan PE. Temporomandibular degenerative

joint diseases: diagnostic procedure and comprehensive

management. J Oral Surg 1975; 40: 297.

Posnick JC, Goldstein JA. Surgical management of the

temporomandibular joint in pediatric population. J Plastic

Reconst Surg 1993; 91: 5791-7.7. Gassner R, Tuli T, Hach O, Rudisch A, Ulmer H.

Craniomaxillofaical trauma: a 10 year review of 9543 cases with

injuries. J Craniomaxillofac Surg 2003;31(1):51-61.8. Iido S, Matsuya T. Pediatric maxillofacial fracture: their

etiological characters and fracture patterns. J Craniomaxillofac

Surg 2002; 30 (4):237-41.

Molla MR, Shrestha KR. An analytic study of surgical

management of temporomandibular joint ankylosis: an

experience in Bangladesh. Banglad Med Res Coune Bull 1996;22: 43-5010. Mofty EL. Ankylosis of temporomandibular joint. Oral Surg

; 33: 650-666.

Jeffrey J, Mose, Henry HLO. Fibrous Ankylosis of the

Temporomandibular Joint. J Orofacial Pain 1995; 9:381-384.

Kaban LB, Perott DH, Fisher K. A Protocol for Management of

Temporomandibular Joint Ankylosis. J Oral Max fac Surg 1990;

: 1145-1151.13. Adekeye EO. Ankylosis of the mandible: analysis of 76 cases. J

Silver MCM, Motamed M, Carlotti WE. Temporomandibular

joint with the use of vitallium condylar prosthesis: report of three

cases. J Oral Surg 1977; 35: 909.Oral Maxillofac Surg 1983; 41: 44215. Lei Z. Auricular cartilage graft interposition after

temporomandibular joint ankylosis surgery in children. J Oral

Max Fac Surg 2002; 60: 985-987.16. Saeed NR, Kent JN. A retrospective study of the costochondral

graft in TMJ reconstruction. Int J Oral Max Fac Surg 2003; 32:


Loon JP, de Bont LGM, Stegenga B, Spijkervet FKL, Verkerke

GJ. Groningen temporomandibular joint prosthesis: development

and first clinical application. Int J Oral Max Fac Surg

;31:44–5218. Steinhauser EW. The treatment of ankylosis in children. Int J

Oral Surg 1973; 2: 129.19. Kiersch TA. Proplast Teflon graft for TMJ surgery. VIII

international conference on oral surgery. Berlin, West Germany,

June 1983.

Verneuil A. De la creation d’une fausse articulation par section

of resection partielle de l’os maxillaire infericure, comme moyen

de remedier al’’nkylose vraie ou fausse de la machoire infereure.

Arch Gen Med 1872; 284-316.

Toyama M, Kurita K, Koga K, Ogi N. Ankylosis of the

temporomandibular joint developing shortly after multiple facial

fractures. Int J Oral Max Fac Surg 2003; 32: 360–362.

Akhtar MU, Ali K, Arain A, Mirza YB, Chaudhry Z. Rationale

for coronoidectomy in the management of temporomandibular

joint ankylosis. J Physicians Surgeons Pakistan 2001; 1(11): 12-14.

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