Abstract

ABSTRACT A variety of techniques for the management of craniomandibular ankylosis have been described. However, no single technique has proved entirely satisfactory. These techniques pose a significant challenge due to a high incidence of recurrence. Aim: The aim of this study was to evaluate and compare between the interpositional auricular graft and local application of chemotherapy procedures. Patients/methods : The study has been used on 31 patients with true TMJ ankylosis (18 had unilateral and13 had bilateral ankylosis with average age ranged between 12 and 41). Two procedures for the management of TMJ ankylosis were done. Group (1) included 16 patients were subjected to small gap arthroplasty and topical application chemotherapeutic agent having antiproliferative property to suppress fibrous proliferation and vascular ingrowth between the osteotomy sites. Group (11) included 15 patients were subjected to interpositional arthroplasty using auricular graft of the ipsilateral side. All patients were examined and followed clinically and radiologically using panoramic view, CT and MRI, after the operation for a period extended to 4 years to confirm absence of recurrence. All patients had no recurrence after surgery. Results : Considerable improvement in maximal incisal opening (33 mm) was noted in all patients during the follow up period. Conclusion : The study concluded that both techniques provided satisfactory results. However, chemical application of chemotherapeutic agent was found to be superior in some aspects; no mandibular shifting during the movement, elimination of grafting problems and saving surgical time.