Ramus Condyle Unit Reconstruction Using L-Shaped Ramus Osteotomy in Temporomandibular Joint Ankylosis

Abstract

Aim and Purpose: To evaluate the feasibility of the L-shaped osteotomy in reconstructing the Ramus Condyle Unit (RCU) after gap arthroplasty in patients with temporomandibular joint (TMJ) ankylosis. Objectives: To evaluate the efficacy of the above procedure by evaluating the increase in mouth opening, by assessing the resorption of the newly reconstructed RCU, by assessing any occlusal disturbances, deviation upon mouth opening and obstructive sleep apnoea, caused by decrease in height of the ramus of the mandible as well as to evaluate complications of the procedure, if any. Materials and Method: 13 patients (22 joints) with TMJ ankylosis along with resection of the ankylosed condyle, underwent L-shaped ramus osteotomy. Patients were followed up for an average of 14.07 months (range 12–17 months). Results: In all patients, increase in mouth opening was noted, from an average of 3.3 mm preoperative to 32.2 mm at maximum follow up. When comparing the height of the newly reconstructed RCU, intraoperative (average 8.6 mm), immediate postoperative (average 7.7 mm) and on last follow up (average 7.7 mm) average bone resorption was insignificant. There was one case of deviation on mouth opening, one case of anterior open bite, one case of reankylosis and hence, successful reconstruction of the RCU. Conclusions: Thus, L osteotomy was effective in RCU reconstruction in patients with TMJ ankylosis. Adequate mouth opening was achieved without any major complications, mandibular ramal bone height was preserved and significant adaptation and remodelling of the neocondyle occurred over time to the normal condyle in terms of shape and improved function.

Keywords: L-shaped ramus osteotomy, ramus condyle unit reconstruction, TMJ ankylosis

Cite this Article

Sonal Anchlia, Nisarg Patel, Jigar Dhuvad et al. Ramus Condyle Unit Reconstruction Using L-Shaped Ramus Osteotomy in Temporomandibular Joint Ankylosis. Research & Reviews: A Journal of Dentistry. 2018; 9(1): 1–10p.