Experience of using arthroplasty for repair of temporomandibular ankylosis

Treatment of patients with bone and fibrous pathology of the temporomandibular joint (TMJ), especially accompanied by secondary osteoarthritis deformans, occupies a special place in the modern maxillofacial surgery. The number of adult patients of all age groups, as well as children and adolescents with this disease has no tendency to decrease, ranging from 53 to 78.8% among disabled people with diseases of the TMJ. Titanium TMJ prostheses have been widely used in clinical practice in recent years, they are stable, universally applicable and not exposed to resorption compared to autogenous bone grafts. Objective. To assess the results of treatment of TMJ with pronounced contracture of the mandible using standard titanium endoprostheses. Patients and methods. Treatment of 5 patients was carried out in special care unit of the multidisciplinary hospital: 4 patients (aged from 32 to 54 years) with TMJ unilateral ankylosis, 1 patient (aged 20 years) with bilateral ankylosis. TMJ prostheses were fixed and stabilized intraoperatively in all patients. Mandibular ramus was lengthened using a TMJ prosthesis on one side in 4 patients with severe mandibular contracture, bilateral osteotomy with arthroplasty by Conmet (Russia) titanium articular endoprostheses was performed in 1 patient. The follow-up period of patients ranged from 12 months to 2 years. Results. No loosening, breakage or infection leading to prosthesis removal have been detected during the whole follow-up period. Conclusion. Experience of using universal titanium prostheses in the arthroplasty has shown their high effectiveness in the treatment of both TMJ unilateral and bilateral ankylosis of various etiologies.