Treatment of temporomandibular joint ankylosis with gap arthroplasty and temporal muscle/fascia graft: a case report with five-year follow-up

• Autor(a) principal: Bortoluzzi, Marcelo Carlos
• Data de Publicação: 2009
• Outros Autores: Sheffer, Miguel Angelo R.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista odonto ciência (Online)
• Texto Completo: https://revistaseletronicas.pucrs.br/ojs/index.php/fo/article/view/4064
• topic: ATM; anquilose; cirurgia buco-maxilo-facial; articulação temporomandibular; Traumatologia; ATM

Purpose: Temporomandibular joint ankylosis (TMA) is a highly distressing condition in which the Temporomandibular Joint (TMJ) is replaced by scar tissue. The most commonly surgical approach used to restore normal joint functioning is a gap arthroplasty associated with the temporal muscle flap (TMF) as interpositional material. This paper aimed to present a modification of the conventional vascularized temporal muscle flap, and describe an alternative procedure using a muscle/fascia temporal graft as interpositional tissue for the gap arthroplasty. Case description: We report a case of TMA treated using a gap arthroplasty and a variation of the TMF technique as interpositional material, performing a temporal muscle/fascia graft. The technique described is associated with adequate bone removal and excellent intraoperative joint mobilization. Physiotherapy was started 2 days after surgery and maintained for 4 months. During the five years of follow-up, no signs of ankylosis recurrence were observed; maximum mouth opening is currently 35 millimeters. Conclusion: The success in preventing reankylosis after TMJ gap arthroplasty is related primarily to the early postoperative physiotherapy, maintained long-term. A free graft harvested from temporal muscle and used as interpositional material is easy to obtain, reliable, and effective. Another advantage is minimal damage to the temporal muscle and low morbidity.