Management of post-traumatic temporomandibular joint ankylosis in children: case report

Temporomandibular joint (TMJ) ankylosis is a distressing affliction that denies the victim the benefit of normal diet, careers that require normal speech and causes severe facial disfigurement that aggravates psychological stress. Opinions in current literature portray controversy in its management. Hurried clinicians take shortcuts and partially treat symptoms and often make the condition worse. Others ignore shortcomings and erroneously prescribe their preferred techniques as absolute indication to the peril of the affected children. Gap arthroplasty if applied in a growing maxillofacial skeleton as in children, causes iatrogenic arrest of facial growth. The intended correction of facial disfigurement is therefore not achieved. Early detection and immediate psychological support by excision and reconstruction of ankylosed TMJ with a costochondral graft, improves patient comfort and rehabilitation when used as a planned part of a comprehensive therapy. This paper questions prior varied opinions and discusses scientific baseline considerations in management of long standing TMJ ankylosis in children in relatively affordable circumstances.