When the lower jaw fuses with the skull bone at its joint (the condyle of the mandible fuses with the glenoid fossa of the temporal bone), it is called Temporomandibular joint ankylosis. It leads to the obliteration of normal articulation and finally immobile lower jaw (mandible).
TMJ ankylosis limits the ability of the person to open the mouth. This creates difficulty in eating food, maintaining hygiene, and even speaking.
It can also lead to impaired growth of the lower jaw and various dental problems.
Normal full mouth opening is around 4-5 cm as measured from the edge of lower front teeth to the edge of upper front teeth.
It may be one-sided or both-sided, with different types of appearance on the face.
1. TMJ ankylosis may be due to any injury over the TMJ region like
2. TMJ ankylosis may be due to any inflammatory condition (like arthritis).
3. TMJ ankylosis may be due to any infection of the ear or due to post-operative complications of TMJ surgery.
It is very commonly seen in children. Usually, they come with zero mouth opening and deformity of the lower jaw. Ankylosis leads to arrest of growth of the lower jaw, so facial asymmetry is common in children
Most of the time, patients or parents of the affected children would have consulted many physicians but the correct diagnosis would not have been reached.
Diagnosis of TMJ ankylosis is mostly clinical but it is supplemented with a few investigations like
Intra-articular (true) ankylosis must be distinguished from extra-articular (false) ankylosis.
False ankylosis may be caused by
In most cases of true ankylosis, x-rays of the joint show loss of normal bony architecture around the TMJ region.
TMJ Ankylosis is completely treatable with surgery. Restoration of mouth opening is the primary aim of treatment. The lower jaw (mandibular) deformity, if present, is usually corrected later during second-stage surgery.
The patient is admitted one day before surgery and all preoperative investigations are done.
Correction of mandibular deformity can be done with orthognathic surgery procedures notably Bilateral Saggital Split Osteotomy (BSSO) and genioplasty or chin surgery. These patients also require orthodontic treatment for correction of the alignment of their teeth.
Orthognathic surgery is usually done as a second-stage procedure when the children have completed their skeletal maturity i.e., 14 to 16 years for girls and 16 to 18 years for boys.
Bilateral Saggital Split Osteotomy (BSSO) should be done when the whole lower jaw is underdeveloped and requires advancement or to be brought forward.
Genioplasty or chin surgery is a single cosmetic procedure that gives the maximum cosmetic correction in boys and girls with receding chins. It is usually combined with BSSO.
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TMJ Ankylosis is a condition where the temporomandibular joint becomes fused, limiting jaw movement. It differs from other TMJ and jaw conditions due to the specific fusion of the joint.
TMJ Ankylosis can result from various causes, including trauma, infections, or genetic factors. Contributing factors may involve untreated jaw injuries or infections.
Symptoms of TMJ Ankylosis include limited jaw movement, pain, and difficulty in chewing and speaking. These symptoms can have a significant impact on an individual’s quality of life.
Diagnosis typically involves a clinical examination by a healthcare professional, along with imaging studies like X-rays or CT scans to confirm the ankylosis and determine its extent.
Management of TMJ Ankylosis often involves a surgical intervention to release the joint fusion and restore jaw mobility. After surgery, post-operative rehabilitation and physiotherapy may be required.
Kayakriti Clinic specializes in TMJ Ankylosis management, offering surgical options and post-operative care. They provide a patient-centric approach to restore normal jaw function and improve the quality of life for affected individuals.
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