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- 1.1. Temporomandibular ankylosis is relatively uncommon, warranting the report and analysis of twenty-two cases.
- 2.2. True bony ankylosis is most frequently caused by infection of trauma; pseudo-ankylosis results from soft tissue fibrosis chiefly following burns, wounds, infection, or irradiation.
- 3.3. Pathology foun at the time of surgery in early cases of true ankylosis is most often an intra-articular fibrosis but in more advanced stages a massive bony hypertrophy is present obliterating the normal landmarks.
- 4.4. Diagnosis is obvious in late cases wherein the pathologic changes commenced during childhood but is difficult as to the side of involvment in adults with a relatively short history of limitation of movement of the jaws.
- 5.5. Clinical signs are often better diagnostic aids than the roentgen examination which is difficult in technique and in interpretation.
- 6.6. Treatment of bony ankylosis is essentially wide resection of the condylar neck with removal of a portion of the condylar head and the ramus if necessary to produce a wide bony gap.
- 7.7. The insertion of cartilage, fascia, or inert substances to fill the gap for the purpose of preventing recurrence is of secondary and minor importance.
- 8.8. Massive overgrowth of bone, especiallyin recurrences after resection, is best treated by cross-sectioning the ramus and interposing muscle between the bone ends to create a false joint.
- 9.9. The treatment of pseudo-ankylosis is directed toward overcoming the soft tissue fibrosis. If early, repeated stretching may be efficacious but, if late and this usually is the case, excision of fibrous bands, scars, or muscle is necessary with coverage by skin grafts or flaps.
- 10.10. Cosmetic improvement is secondary to function. The deviated chin and jaw line can be improved by implants of cartilage or by lengthening the short side of the mandible
- 11.11. The twenty-two cases reported are analyzed as to etiology, pathology, and treatment (see Table I).
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☆Read at the meeting of the Society of University Surgeons, New Orleans, La., Jan. 29–31, 1948.
© 1948 Published by Elsevier Inc.