Posttraumatic temporomandibular joint ankylosis in adults: is it mandatory to perform interposition arthroplasty?

Ankylosis of the temporomandibular joint (TMJ) is a severe disorder that leads to jaw function impairment and restricted mouth opening. Management of TMJ ankylosis poses a challenge to surgeons concerned because of the high rate of recurrence. The surgical approach to TMJ ankylosis can be performed according to different techniques and modalities. This report presents a case of a bilateral posttraumatic TMJ ankylosis that showed limited mouth opening (27 mm) along with dental occlusion abnormalities, and both TMJs showed severe fibro-osseous ankylosis. Bilateral gap arthroplasty was performed, and passive interincisal mouth opening of at least 47 mm was achieved after 15 days of physiotherapy. Eight months later, bilateral split ramus osteotomy was performed to correct the residual retrognathia and malocclusion. The outcome of the patient's treatment was satisfactory. Wide gap arthroplasty if followed by vigorous physiotherapy may be sufficient in treating TMJ ankylosis and prevent recurrence in adults.