A comparative study of outcomes of two surgical procedures used to manage intracapsular ankylosis of the temporomandibular joint

• Main Author: Milad, Abdusalam A
• Format: Others
• Language: en
• Published: 2018
• Online Access: https://hdl.handle.net/10539/25259

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Science in Dentistry in the department of Maxillo-Facial and Oral Surgery, 2018 === Introduction: Temporomandibular joint (TMJ) ankylosis may be defined as the fusion of joint surfaces with bony or fibrous tissue which causes limitations on the functional activities of the oral cavity. Surgical treatment includes gap arthroplasty (GA), interpositional Arthroplasty (IA) and joint reconstruction using costochondral graft (CCG), iliac crest, clavicular, fibular, and metatarsal or alloplastic prosthesis and distraction osteogenesis. Aim and objectives: The aim of this retrospective study was to compare outcomes of GA with CCG. The objectives were to identify factors that are associated with surgical outcomes, to identify the age group that is commonly affected and to compare the mean maximum interincisal opening (MIO) in two surgical procedures. Materials and Methods: This retrospective study evaluated outcomes of 40 patients who were treated with GA and CCG between February 2007 and December 2016. The data were analysed and classified into pre-operative, intra-operative and post-operative stages. The outcomes were evaluated by calculating an achieved MIO (final MIO – preoperative MIO), and post-operative change in MIO (Op MIO - final MIO) and the final MIO, which refers to the last recorded MIO. Results: Forty patients met the criteria for this study, twenty-seven were males and thirteen were females, the age range was 2 to 55 years. Trauma was the main cause of ankylosis with (62%) (n=26), followed by congenital defects with (27.5%) (n=11) and infection with (7.5%) (n=3). The mean of the final MIO of GA and with CCG was 30 mm (SD= 7.31) and 29.47 mm (SD= 6.79) respectively. The mean of A-MIO for GA and with CCG was 22.76 mm (SD= 8.61) and 24.1 mm (SD= 7.16) respectively, while the Pop-MIO for GA and with CCG was -3.85 mm (SD= 10.11) and -2.10 mm (SD= 7.49) respectively. The results showed no statistically significant difference (P > 0.05) in the mean MIO between two groups under GA v and CCG. In addition, it showed no association between the complications, age, gender and aetiology that were investigated by using logistic regression. Conclusion: The findings of this study suggest that there is no difference in surgical outcomes between GA and IA with CCG, and the most common age groups that was affected was third stage 20-29 years (42.5%), with no association between factors and surgical outcomes. === XL2018