International Journal of Advances In Case Reports

MANAGEMENT OF 33YEARS OLD ANKYLOSIS OF PARTIALLY EDENTULOUS PATIENT WITH GAP ARTHROPLASTY

Mahesh Goel1*, Manu Rathee2, Anita Hooda3, Rajiv Tanwar4, Neeraj4, Manju Thepra4

drmaheshgoelos@gmail.com

Chronic mandibular hypomobility, Temporomandibular joint, Ankylosis.

The predominant feature of chronic mandibular hypomobility is the inability of the patient to open the mouth to normal range. It is rarely accompanied by painful symptoms or progressive destructive changes. By definition, ankylosis means abnormal immobility of a joint. Ankylosis of the temporomandibular joint (TMJ) is an intracapsular union of the disc-condyle complex to the temporal articular surface that restricts mandibular movements, including the fibrous adhesions or bony fusion between condyle, disc, glenoid fossa, and eminence. The patient is aware that this condition has been present for a long time and may not feel that it poses a significant problem. A 48 years old female patient with 33years old long standing unilateral ankylosis with progressive chronic hypomobility of partially edentulous mandible was treated with gap arthroplasty with bilateral coronoidectomy. The patient generally has some movement though restricted, definitive treatment may not be indicated. If function is inadequate or the restriction is intolerable, surgery is the only definitive treatment available. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. The most frequently reported operations include gap arthroplasty, interpositional arthroplasty and joint reconstruction with autogenous or alloplastic materials. In the present case we did Gap arthroplasty with stripping of muscles along with bilateral coronoidectomy. Gap arthroplasty alone gives rise to a gap between the articular cavity and the mandibular ramus and has the advantage of simplicity and short operating time. In the present case of Chronic mandibular hypomobility due to long standing unilateral ankylosis, the management of patient with Gap arthroplasty along with bilateral coronoidectomy have shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.