Bilateral alloplastic total temporomandibular joint reconstruction in a five-year-old child: A case report and a review of the literature

Temporomandibular joint (TMJ) ankylosis can lead to complete or partial obliteration of the articular space and subsequent limited mouth opening. In children, ankylosis may lead to growth disturbance of the mandible, facial deformity, obstructive sleep apnea, impaired mastication and speech with subsequent nutritional deficiencies. Reconstruction of the condyle to restore facial deformities and TMJ function is recommended as soon as ankylosis is diagnosed. Surgical treatment options vary based on age, type and extent of the ankylosis and whether its uni-or bilateral. Different treatment modalities, such as distraction osteogenesis, gap arthroplasty, costochondral graft (CCG), sternoclavicular graft and alloplastic total joint reconstruction (ATJR) are common reconstruction choices.

We present a case of a long lasting bilateral TMJ ankylosis in a 5-year-old boy with severe OSA who was treated with bilateral alloplastic total joint reconstruction with successful outcome. Even though ATJR in growing children is controversial, the potential benefits of function and quality of life should to be considered in selected cases.