Preservation of disc for treatment of traumatic TMJ ankylosis

Objective: A new operating method was used to treat traumatic temporomandibular joint (TMJ) ankylosis and to restore the structure of TMJ and to improve the secondary maxillofacial deformity and to prevent recurrence of TMJ ankylosis. Method: Thirty-six patients (twenty females and sixteen males, 5 to 54 years old) with TMJ ankylosis type II or III of 1 to 16 years' duration, a maximal mouth opening from 0 to 15 mm preoperatively. The new method was to separate bony fusion between condyle and glenoid fossa, remove the condylar fragment which displaced anteriomedially, and to mobilize the remains of disc over the condylar stump and suture it with articular capsule, shave the surface of condylar stump and glenoid fossa smoothly. Result: Follow-up was performed from 1 year to 7 years postoperatively in 17 cases. There were no recurrence occurred in patients whose TMJ disc were retained during operation. The patients had an average maximal mouth opening of 33.6 mm postoperatively. An 11 years old young patient showed an improved facial symmetry after operation. Conclusion: To restore the normal structure of TMJ and preserve the disc play a very important role in preventing recurrence of traumatic TMJ ankylosis and improving facial deformity in younger patient.