Temporomandibular joint ankylosis pattern, causes, and management among pediatric patient attending a tertiary hospital in Bangladesh

Abstract

Background: Temporomandibular joint (TMJ) ankylosis is a pathological condition where mandibular condyle fused the glenoid fossa of the temporal bone. It causes distressing and disabling conditions to the patient. The purpose of our study is to determine the frequency of pediatric TMJ ankylosis attending at Oral and Maxillofacial Surgery Department, Dhaka Dental College and Hospital, Bangladesh. Methodology: This was a retrospective, cross-sectional study for 18 patients (9 male and 9 female) aged up to 18 years old. Data assembled from the patient's surgical records reviewed from January 2016 to December 2018. Results: Females and males were affected equally, the most affected age group was 7–12 as well as 13–18 years old (n = 7, 38.89%), bilateral ankylosis (n = 11, 61.11%) was more common than unilateral (n = 7, 38.89). Type III (34.48%) ankylosis (Sawhney's classification) was found to be the most frequent type. Trauma (n = 11, 61.10%) was the major etiologic factor for pediatric TMJ ankylosis. All patients were managed by surgical intervention. Gap arthroplasty (n = 9; 50.0%) was the most preferable treatment method followed by interpositional arthroplasty (n = 7, 38.89%) and condylectomy (n = 2, 11.11%). Conclusion: The majority of the patient was affected by trauma. Most of the patients came with Type III ankylosis with having facial deformities. Absolute and proper management regarding mandibular condylar fracture and infection (middle ear) must be required to prevent TMJ ankylosis. Surgical intervention is the only treatment option for managing TMJ ankylosis. Aggressive physiotherapy is mandatory to prevent reankylosis, thus ensuring the patient's quality of life.