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Ankylosis (Temporomandibular Joint)

Ankylosis means fusion of a joint - the fusing together of the bones forming the joint or by the formation of calcium deposits around the ligaments - and can occur either unilaterally or bilaterally, depending on the cause. In the temporomandibular joint (TMJ), ankylosis is most frequently caused by poorly-healing severe trauma or infection. However, it can also occur congenitally, or secondary to severe rheumatoid arthritis or to tumors in the area of the TMJ. In congenital cases, or in children in whom the jaw is still growing, ankylosis can arrest the growth of the lower jaw and cause the face to become asymmetrical.

Symptoms

The chief symptom is a decrease in TMJ range of motion. This results in an inability to chew properly and can make oral hygiene very difficult. In very severe cases it can even cause problems with speech. Ankylosis does not usually cause pain, though pain may be experienced depending on the cause of the condition.

Diagnosis

A dentist or oral surgeon will diagnose the severity of ankylosis by observing the degree to which mouth opening is inhibited. X-rays or other imaging tests such as CT scans or MRI can determine abnormalities in the bony or soft tissue formations in the joint.

Treatment

Jaw exercises may temporarily help to decrease the immobility of the joint in some ankylosis cases, but in most cases treatment of ankylosis will require surgery.

Treatment of ankylosis of the jaw joint involves open surgery to remove the condyle, the rounded end of the lower jaw bone that forms the TMJ. The removed condyle is then replaced with a prosthetic condyle. After the surgery, extensive physical therapy usually plays a crucial role in restoring proper TMJ function.

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