What are 
Temporomandibular Joint Ankylosis
 ?

Temporomandibular Joint ankylosis is the condition where in the mandibular condyle fuses with the temporal bone (cranial base), thereby resulting in reduced mouth opening. TMJ ankylosis more commonly affect the younger or the pediatric age group. The causes for it can be ear infection, birth trauma, trauma during infancy or childhood or even congenital.

Symptom of 
Temporomandibular Joint Ankylosis
 ?
Most common presenting symptom of TMJ ankylosis is progressive reduction in mouth opening. This directly relates to reduced dietary intake and poor overall growth of the individual. The earlier the ankylosis sets in, the more pronounced affects it has on the growth of the child. As a result, other than just reduced mouth opening, the child also develops facial asymmetry. It results in flattening of one side of the face, shortened mandible, deviation of midline and also malocclusion. If the ankylosis is bilateral, it leads to severely malformed mandible. In severe cases, these shortened mandible causes decreased airway space thereby causing Obstructive sleep apnea or commonly observed as snoring.
TMJ ankylosis case- difficulty opening mouth
Reasons of 
Temporomandibular Joint Ankylosis
 ?

In adults, the most common reason for TMJ Ankylosis is untreated or undetected mandibular condylar fracture. If the mandibular condyle fracture goes undetected or is not treated in a proper manner, it causes unorganised healing of the fracture fragments and frequently leads to the union of mandibular bone with the temporal bone of the cranium. This union initially is in fibrous form and gradually progresses to a more rigid bony ankylosis.

temporomandibular joint highlighted
For this reason, it is important to assess every trauma to facial region minutely to rule out any condylar fracture. If condylar fracture is diagnosed, it becomes imperative to manage it appropriately to prevent complications like TMJ Ankylosis. In adults the treatment of TMJ ankylosis is release of ankylosis and reconstruction of the joint with various materials available. But the treatment in children is more challenging as it generally causes malformation of mandible as well. For this reason, the treatment options in children vary from simple ankylosis release with or without distraction osteogenesis to guide the mandible to a proper growth. One important complication of TMJ ankylosis surgery is the risk of re-ankylosis and the single most common cause for it is the failure of the patient to comply with the post-operative physiotherapy regime. Also in some cases, it is required to carry out orthognathic surgery at a later date to correct any residual deformity.

TMJ is a very unique joint as it helps us to carry out various important functions like chewing our food, and speech. A life with a closed mouth for years can be very debilitating and no individual should be forced to live like that. Best way to manage such condition is detection at the earliest stage possible and rendering proper treatment!

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