J Korean Assoc Oral Maxillofac Surg.  2021 Aug;47(4):239-248. 10.5125/jkaoms.2021.47.4.239.

Classification and surgical management of temporomandibular joint ankylosis: a review

• Upadya VH
• Bhat HK
• Rao BS
• Reddy SG

• KMID: 2519821
• DOI: http://doi.org/10.5125/jkaoms.2021.47.4.239

Abstract

The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/ CAM can efficiently overcome the shortcomings of stock prostheses.

Keyword

Temporomandibular joint; Ankylosis; Classification; Arthroplasty; Distraction osteogenesis

Reference

References

1. Saeed NR, McLeod NM, Hensher R. 2001; Temporomandibular joint replacement in rheumatoid-induced disease. Br J Oral Maxillofac Surg. 39:71–5. https://doi.org/10.1054/bjom.2000.0565 . DOI: 10.1054/bjom.2000.0565. PMID: 11178860.

2. Ma J, Liang L, Jiang H, Gu B. 2015; Gap arthroplasty versus interpositional arthroplasty for temporomandibular joint ankylosis: a meta-analysis. PLoS One. 10:e0127652. https://doi.org/10.1371/journal.pone.0127652 . DOI: 10.1371/journal.pone.0127652. PMID: 26010224. PMCID: PMC4444315.

3. Roychoudhury A, Parkash H, Trikha A. 1999; Functional restoration by gap arthroplasty in temporomandibular joint ankylosis: a report of 50 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 87:166–9. https://doi.org/10.1016/s1079-2104(99)70267-2 . DOI: 10.1016/s1079-2104(99)70267-2. PMID: 10052370.

4. Kazanjian VH. 1938; Ankylosis of the temporomandibular joint. Am J Orthod Oral Surg. 24:1181–206. https://doi.org/10.1016/S0096-6347(38)90337-0 . DOI: 10.1016/0096-6347(46)90219-0. PMID: 21013450.

5. Topazian RG. 1966; Comparison of gap and interposition arthroplasty in the treatment of temporomandibular joint ankylosis. J Oral Surg. 24:405–9. PMID: 5328700.

6. Sawhney CP. 1986; Bony ankylosis of the temporomandibular joint: follow-up of 70 patients treated with arthroplasty and acrylic spacer interposition. Plast Reconstr Surg. 77:29–40. PMID: 3941847.

7. Durr ED, Turlington EG, Foote RL. 1993; Radiation treatment of heterotopic bone formation in the temporomandibular joint articulation. Int J Radiat Oncol Biol Phys. 27:863–9. DOI: 10.1016/0360-3016(93)90461-4. PMID: 8244816.

8. El-Hakim IE, Metwalli SA. 2002; Imaging of temporomandibular joint ankylosis. A new radiographic classification. Dentomaxillofac Radiol. 31:19–23. https://doi.org/10.1038/sj/dmfr/4600660 . DOI: 10.1038/sj/dmfr/4600660. PMID: 11803384.

9. He D, Yang C, Chen M, Zhang X, Qiu Y, Yang X, et al. 2011; Traumatic temporomandibular joint ankylosis: our classification and treatment experience. J Oral Maxillofac Surg. 69:1600–7. https://doi.org/10.1016/j.joms.2010.07.070 . DOI: 10.1016/j.joms.2010.07.070. PMID: 21295900.

10. Braimah RO, Taiwo AO, Ibikunle AA, Oladejo T, Adeyemi M, Adejobi AF, et al. 2018; Temporomandibular joint ankylosis with maxillary extension: proposal for modification of Sawhney's classification. Craniomaxillofac Trauma Reconstr Open. 2:e15–21. https://doi.org/10.1055/s-0038-1666852 .

11. Xia L, An J, He Y, Xiao E, Chen S, Yan Y, et al. 2019; Association between the clinical features of and types of temporomandibular joint ankylosis based on a modified classification system. Sci Rep. 9:10493. https://doi.org/10.1038/s41598-019-46519-8 . DOI: 10.1038/s41598-019-46519-8. PMID: 31324825. PMCID: PMC6642162.

12. Kim SG. 2001; Treatment of temporomandibular joint ankylosis with temporalis muscle and fascia flap. Int J Oral Maxillofac Surg. 30:189–93. https://doi.org/10.1054/ijom.2001.0047 . DOI: 10.1054/ijom.2001.0047. PMID: 11420899.

13. Dimitroulis G. 2004; The interpositional dermis-fat graft in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg. 33:755–60. https://doi.org/10.1016/j.ijom.2004.01.012 . DOI: 10.1016/j.ijom.2004.01.012. PMID: 15556322.

14. Babu L, Jain MK, Ramesh C, Vinayaka N. 2013; Is aggressive gap arthroplasty essential in the management of temporomandibular joint ankylosis?-a prospective clinical study of 15 cases. Br J Oral Maxillofac Surg. 51:473–8. https://doi.org/10.1016/j.bjoms.2012.11.004 . DOI: 10.1016/j.bjoms.2012.11.004. PMID: 23219020.

15. Rajan R, Reddy NV, Potturi A, Jhawar D, Muralidhar PV, Reddy B. 2014; Gap arthroplasty of temporomandibular joint ankylosis by transoral access: a case series. Int J Oral Maxillofac Surg. 43:1468–72. https://doi.org/10.1016/j.ijom.2014.08.010 . DOI: 10.1016/j.ijom.2014.08.010. PMID: 25240622.

16. Tanrikulu R, Erol B, Görgün B, Söker M. 2005; The contribution to success of various methods of treatment of temporomandibular joint ankylosis (a statistical study containing 24 cases). Turk J Pediatr. 47:261–5. PMID: 16250312.

17. Ramezanian M, Yavary T. 2006; Comparion of gap arthroplasty and interpositional gap arthroplasty on the temporomandibular joint ankylosis. Acta Med Iran. 44:391–4.

18. Zhi K, Ren W, Zhou H, Gao L, Zhao L, Hou C, et al. 2009; Management of temporomandibular joint ankylosis: 11 years' clinical experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108:687–92. https://doi.org/10.1016/j.tripleo.2009.06.041 . DOI: 10.1016/j.tripleo.2009.06.041. PMID: 19782622.

19. Danda AK, Chinnaswami R. S R. 2009; Comparison of gap arthroplasty with and without a temporalis muscle flap for the treatment of ankylosis. J Oral Maxillofac Surg. 67:1425–31. https://doi.org/10.1016/j.joms.2008.12.049 . DOI: 10.1016/j.joms.2008.12.049. PMID: 19531413.

20. Elgazzar RF, Abdelhady AI, Saad KA, Elshaal MA, Hussain MM, Abdelal SE, et al. 2010; Treatment modalities of TMJ ankylosis: experience in Delta Nile, Egypt. Int J Oral Maxillofac Surg. 39:333–42. https://doi.org/10.1016/j.ijom.2010.01.005 . DOI: 10.1016/j.ijom.2010.01.005. PMID: 20149597.

21. Mansoor N, Khan M, Mehboob B, Din Q. 2013; Gap vs interpositional arthroplasty in the management of temporomandibular joint ankylosis. Pak Oral Dent J. 33:8–12.

22. Holmlund A, Lund B, Weiner CK. 2013; Mandibular condylectomy with osteoarthrectomy with and without transfer of the temporalis muscle. Br J Oral Maxillofac Surg. 51:206–10. https://doi.org/10.1016/j.bjoms.2012.05.011 . DOI: 10.1016/j.bjoms.2012.05.011. PMID: 22789423.

23. Shaikh SK, Mishra M, Tiwari AK, Chander M, Gaur A, Singh H. 2013; Comparative evaluation of gap arthroplasty and interpositional arthroplasty using temporalis fascia in the management of temporomandibular joint ankylosis. J Orofac Res. 3:170–4.

24. Bhatt K, Roychoudhury A, Bhutia O, Pandey RM. 2014; Functional outcomes of gap and interposition arthroplasty in the treatment of temporomandibular joint ankylosis. J Oral Maxillofac Surg. 72:2434–9. https://doi.org/10.1016/j.joms.2014.08.012 . DOI: 10.1016/j.joms.2014.08.012. PMID: 25315308.

25. Bansal V, Singh S, Garg N, Dubey P. 2014; Transport distraction osteogenesis as a method of reconstruction of the temporomandibular joint following gap arthroplasty for post-traumatic ankylosis in children: a clinical and radiological prospective assessment of outcome. Int J Oral Maxillofac Surg. 43:227–36. https://doi.org/10.1016/j.ijom.2013.07.745 . DOI: 10.1016/j.ijom.2013.07.745. PMID: 24016549.

26. Bayat M, Badri A, Moharamnejad N. 2009; Treatment of temporomandibular joint ankylosis: gap and interpositional arthroplasty with temporalis muscle flap. Oral Maxillofac Surg. 13:207–12. https://doi.org/10.1007/s10006-009-0174-4 . DOI: 10.1007/s10006-009-0174-4. PMID: 19806372.

27. Guruprasad Y, Chauhan DS, Cariappa KM. 2010; A retrospective study of temporalis muscle and fascia flap in treatment of TMJ ankylosis. J Maxillofac Oral Surg. 9:363–8. https://doi.org/10.1007/s12663-010-0139-z . DOI: 10.1007/s12663-010-0139-z. PMID: 22190825. PMCID: PMC3177478.

28. Chossegros C, Guyot L, Cheynet F, Blanc JL, Gola R, Bourezak Z, et al. 1997; Comparison of different materials for interposition arthroplasty in treatment of temporomandibular joint ankylosis surgery: long-term follow-up in 25 cases. Br J Oral Maxillofac Surg. 35:157–60. https://doi.org/10.1016/s0266-4356(97)90554-4 . DOI: 10.1016/s0266-4356(97)90554-4. PMID: 9212289.

29. Thangavelu A, Santhosh Kumar K, Vaidhyanathan A, Balaji M, Narendar R. 2011; Versatility of full thickness skin-subcutaneous fat grafts as interpositional material in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg. 40:50–6. https://doi.org/10.1016/j.ijom.2010.06.025 . DOI: 10.1016/j.ijom.2010.06.025. PMID: 20952163.

30. Malhotra VL, Singh V, Rao JD, Yadav S, Gupta P, Shyam R, et al. 2019; Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis. J Korean Assoc Oral Maxillofac Surg. 45:129–34. https://doi.org/10.5125/jkaoms.2019.45.3.129 . DOI: 10.5125/jkaoms.2019.45.3.129. PMID: 31334100. PMCID: PMC6620302.

31. Shakeel M, Imran M, Ahad B, Shafi M, Khan A. 2016; Surgical treatment of temporomandibular joint ankylosis: skims experience of 105 cases. Int J Med Res Health Sci. 5:77–82.

32. Sharma H, Chowdhury S, Navaneetham A, Upadhyay S, Alam S. 2015; Costochondral graft as interpositional material for TMJ ankylosis in children: a clinical study. J Maxillofac Oral Surg. 14:565–72. https://doi.org/10.1007/s12663-014-0686-9 . DOI: 10.1007/s12663-014-0686-9. PMID: 26225045. PMCID: PMC4510084.

33. Qudah MA, Qudeimat MA, Al-Maaita J. 2005; Treatment of TMJ ankylosis in Jordanian children - a comparison of two surgical techniques. J Craniomaxillofac Surg. 33:30–6. https://doi.org/10.1016/j.jcms.2004.07.005 . DOI: 10.1016/j.jcms.2004.07.005. PMID: 15694147.

34. Manganello-Souza LC, Mariani PB. 2003; Temporomandibular joint ankylosis: report of 14 cases. Int J Oral Maxillofac Surg. 32:24–9. https://doi.org/10.1054/ijom.2002.0308 . DOI: 10.1054/ijom.2002.0308. PMID: 12653228.

35. Balaji SM. 2003; Modified temporalis anchorage in craniomandibular reankylosis. Int J Oral Maxillofac Surg. 32:480–5. PMID: 14759105.

36. Loveless TP, Bjornland T, Dodson TB, Keith DA. 2010; Efficacy of temporomandibular joint ankylosis surgical treatment. J Oral Maxillofac Surg. 68:1276–82. https://doi.org/10.1016/j.joms.2009.10.014 . DOI: 10.1016/j.joms.2009.10.014. PMID: 20304543.

37. Tang W, Long J, Feng F, Guo L, Gao C, Tian W. 2009; Condyle replacement after tumor resection: comparison of individual prefabricated titanium implants and costochondral grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108:147–52. https://doi.org/10.1016/j.tripleo.2009.01.028 . DOI: 10.1016/j.tripleo.2009.01.028. PMID: 19386520.

38. Chen S, He Y, An JG, Zhang Y. 2019; Recurrence-related factors of temporomandibular joint ankylosis: a 10-year experience. J Oral Maxillofac Surg. 77:2512–21. https://doi.org/10.1016/j.joms.2019.06.172 . DOI: 10.1016/j.joms.2019.06.172. PMID: 31348873.

39. Sahoo NK, Tomar K, Kumar A, Roy ID. 2012; Selecting reconstruction option for TMJ ankylosis: a surgeon's dilemma. J Craniofac Surg. 23:1796–801. https://doi.org/10.1097/SCS.0b013e318270fab5 .

40. Wolford LM, Morales-Ryan CA, Morales PG, Cassano DS. 2008; Autologous fat grafts placed around temporomandibular joint total joint prostheses to prevent heterotopic bone formation. Proc (Bayl Univ Med Cent). 21:248–54. https://doi.org/10.1080/08998280.2008.11928404 . DOI: 10.1080/08998280.2008.11928404. PMID: 18628972. PMCID: PMC2446413.

41. Wolford LM, Mercuri LG, Schneiderman ED, Movahed R, Allen W. 2015; Twenty-year follow-up study on a patient-fitted temporomandibular joint prosthesis: the Techmedica/TMJ Concepts device. J Oral Maxillofac Surg. 73:952–60. https://doi.org/10.1016/j.joms.2014.10.032 . DOI: 10.1016/j.joms.2014.10.032. PMID: 25631865.

42. Mercuri LG. 2011; Patient-fitted ("custom") alloplastic temporomandibular joint replacement technique. Atlas Oral Maxillofac Surg Clin North Am. 19:233–42. https://doi.org/10.1016/j.cxom.2011.05.001 .

43. Mercuri LG. 2012; Alloplastic temporomandibular joint replacement: rationale for the use of custom devices. Int J Oral Maxillofac Surg. 41:1033–40. https://doi.org/10.1016/j.ijom.2012.05.032 . DOI: 10.1016/j.ijom.2012.05.032. PMID: 22771166.

44. Wolford LM, Karras SC. 1997; Autologous fat transplantation around temporomandibular joint total joint prostheses: preliminary treatment outcomes. J Oral Maxillofac Surg. 55:245–51. discussion 251–2. https://doi.org/10.1016/s0278-2391(97)90535-8 . DOI: 10.1016/s0278-2391(97)90535-8. PMID: 9054913.

45. Wolford L, Movahed R, Teschke M, Fimmers R, Havard D, Schneiderman E. 2016; Temporomandibular joint ankylosis can be successfully treated with TMJ concepts patient-fitted total joint prosthesis and autogenous fat grafts. J Oral Maxillofac Surg. 74:1215–27. https://doi.org/10.1016/j.joms.2016.01.017 . DOI: 10.1016/j.joms.2016.01.017. PMID: 26878364.

46. Mercuri LG, Ali FA, Woolson R. 2008; Outcomes of total alloplastic replacement with periarticular autogenous fat grafting for management of reankylosis of the temporomandibular joint. J Oral Maxillofac Surg. 66:1794–803. https://doi.org/10.1016/j.joms.2008.04.004 . DOI: 10.1016/j.joms.2008.04.004. PMID: 18718385.

47. ShanYong Z, Liu H, Yang C, Zhang X, Abdelrehem A, Zheng J, et al. 2015; Modified surgical techniques for total alloplastic temporomandibular joint replacement: one institution's experience. J Craniomaxillofac Surg. 43:934–9. https://doi.org/10.1016/j.jcms.2015.03.028 .

48. Selbong U, Rashidi R, Sidebottom A. 2016; Management of recurrent heterotopic ossification around total alloplastic temporomandibular joint replacement. Int J Oral Maxillofac Surg. 45:1234–6. https://doi.org/10.1016/j.ijom.2016.02.017 . DOI: 10.1016/j.ijom.2016.02.017. PMID: 27283210.

49. Roychoudhury A, Yadav R, Bhutia O, Aggrawal B, Soni B, Gowswami D, et al. 2017; Is total joint replacement along with fat grafts a new protocol for adult temporomandibular joint ankylosis treatment? Int J Oral Maxillofac Surg. 46:236. https://doi.org/10.1016/j.ijom.2017.02.797 .

50. Braimah R, Taiwo A, Ibikunle A, Oladejo T, Adeyemi M, Adejobi F, et al. 2018; Clinical experience in managing temporomandibular joint ankylosis: five-year appraisal in a Nigerian subpopulation. J Korean Assoc Oral Maxillofac Surg. 44:112–9. https://doi.org/10.5125/jkaoms.2018.44.3.112 . DOI: 10.5125/jkaoms.2018.44.3.112. PMID: 29963492. PMCID: PMC6024065.

51. Park MW, Eo MY, Seo BY, Nguyen TTH, Kim SM. 2019; Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients. Maxillofac Plast Reconstr Surg. 41:18. https://doi.org/10.1186/s40902-019-0200-x . DOI: 10.1186/s40902-019-0200-x. PMID: 31058106. PMCID: PMC6473019.

52. Lin CL, Kuo YC, Lo LJ. 2005; Design, manufacture and clinical evaluation of a new TMJ exerciser. Biomed Eng. 17:135–40. https://doi.org/10.4015/S1016237205000214 .

53. Shirani G, Mohammadi F, Arshad M, Shirazi M. 2014; Temporomandibular joint ankylosis: case-series of two different surgical procedures. Dent Hypotheses. 5:103–8. https://doi.org/10.4103/2155-8213.136754 .

54. Ma Y, Huang Y, Zhu S, Li Y. 2019; Simultaneous arthroplasty and distraction osteogenesis for the treatment of ankylosis of the temporomandibular joint and secondary mandibular deformities in children. Br J Oral Maxillofac Surg. 57:135–9. https://doi.org/10.1016/j.bjoms.2018.11.016 . DOI: 10.1016/j.bjoms.2018.11.016. PMID: 30600109.

55. Zhang W, Yang X, Zhang Y, Zhao T, Jia J, Chang S, et al. 2018; The sequential treatment of temporomandibular joint ankylosis with secondary deformities by distraction osteogenesis and arthroplasty or TMJ reconstruction. Int J Oral Maxillofac Surg. 47:1052–9. https://doi.org/10.1016/j.ijom.2018.01.022 . DOI: 10.1016/j.ijom.2018.01.022. PMID: 29706239.

56. Mehrotra D, Vishwakarma K, Chellapa AL, Mahajan N. 2016; Pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities. Int J Oral Maxillofac Surg. 45:820–7. https://doi.org/10.1016/j.ijom.2015.10.009 . DOI: 10.1016/j.ijom.2015.10.009. PMID: 26780926.

57. Anchlia S, Vyas SM, Dayatar RG, Domadia HL, Nagavadiya V. 2019; Guidelines for single-stage correction of TMJ ankylosis, facial asymmetry and OSA in adults. J Maxillofac Oral Surg. 18:419–27. https://doi.org/10.1007/s12663-018-1121-4 . DOI: 10.1007/s12663-018-1121-4. PMID: 31371885. PMCID: PMC6639443.

58. Sharma R, Manikandhan R, Sneha P, Parameswaran A, Kumar JN, Sailer HF. 2017; Neocondyle distraction osteogenesis in the management of temporomandibular joint ankylosis: report of five cases with review of literature. Indian J Dent Res. 28:269–74. https://doi.org/10.4103/ijdr.IJDR_292_13 . DOI: 10.4103/ijdr.IJDR_292_13. PMID: 28721990.

59. Gabbay JS, Heller JB, Song YY, Wasson KL, Harrington H, Bradley JP. 2006; Temporomandibular joint bony ankylosis: comparison of treatment with transport distraction osteogenesis or the Matthews device arthroplasty. J Craniofac Surg. 17:516–22. https://doi.org/10.1097/00001665-200605000-00022 . DOI: 10.1097/00001665-200605000-00022. PMID: 16770191.

60. Boyd SB. 2009; Management of obstructive sleep apnea by maxillomandibular advancement. Oral Maxillofac Surg Clin North Am. 21:447–57. https://doi.org/10.1016/j.coms.2009.09.001 . DOI: 10.1016/j.coms.2009.09.001. PMID: 19944345.

61. Vijaya Krishnan P, Raghunandhan S, Anand Kumar RS, Kameswaran M. 2014; A rational approach to the management of obstructive sleep apnea syndrome. Indian J Otolaryngol Head Neck Surg. 66(Suppl 1):138–46. https://doi.org/10.1007/s12070-011-0381-9 . DOI: 10.1007/s12070-011-0381-9. PMID: 24533373. PMCID: PMC3918327.

62. Zanaty O, El Metainy S, Abo Alia D, Medra A. 2016; Improvement in the airway after mandibular distraction osteogenesis surgery in children with temporomandibular joint ankylosis and mandibular hypoplasia. Paediatr Anaesth. 26:399–404. https://doi.org/10.1111/pan.12869 . DOI: 10.1111/pan.12869. PMID: 26909508.

63. Bouchard C, Troulis MJ, Kaban L. 2009; Management of obstructive sleep apnea: role of distraction osteogenesis. Oral Maxillofac Surg Clin North Am. 21:459–75. https://doi.org/10.1016/j.coms.2009.07.001 . DOI: 10.1016/j.coms.2009.07.001. PMID: 19944346.

64. Sesenna E, Magri AS, Magnani C, Brevi BC, Anghinoni ML. 2012; Mandibular distraction in neonates: indications, technique, results. Ital J Pediatr. 38:7. https://doi.org/10.1186/1824-7288-38-7 . DOI: 10.1186/1824-7288-38-7. PMID: 22300418. PMCID: PMC3293018.

65. Flores RL. 2014; Neonatal mandibular distraction osteogenesis. Semin Plast Surg. 28:199–206. https://doi.org/10.1055/s-0034-1390173 . DOI: 10.1055/s-0034-1390173. PMID: 25383055. PMCID: PMC4219917.

66. Ching JA, Daggett JD, Alvarez SA, Conley CL, Ruas EJ. 2017; A simple mandibular distraction protocol to avoid tracheostomy in patients with Pierre Robin sequence. Cleft Palate Craniofac J. 54:210–5. https://doi.org/10.1597/14-211 . DOI: 10.1597/14-211. PMID: 26068388.

67. Tahiri Y, Viezel-Mathieu A, Aldekhayel S, Lee J, Gilardino M. 2014; The effectiveness of mandibular distraction in improving airway obstruction in the pediatric population. Plast Reconstr Surg. 133:352e–9e. https://doi.org/10.1097/01.prs.0000438049.29258.a8 . DOI: 10.1097/01.prs.0000438049.29258.a8. PMID: 24572880.

68. Genecov DG, Barceló CR, Steinberg D, Trone T, Sperry E. 2009; Clinical experience with the application of distraction osteogenesis for airway obstruction. J Craniofac Surg. 20 Suppl 2:1817–21. https://doi.org/10.1097/SCS.0b013e3181b6c1b0 . DOI: 10.1097/SCS.0b013e3181b6c1b0. PMID: 19816357.

69. Lam DJ, Tabangin ME, Shikary TA, Uribe-Rivera A, Meinzen-Derr JK, de Alarcon A, et al. 2014; Outcomes of mandibular distraction osteogenesis in the treatment of severe micrognathia. JAMA Otolaryngol Head Neck Surg. 140:338–45. https://doi.org/10.1001/jamaoto.2014.16 . DOI: 10.1001/jamaoto.2014.16. PMID: 24577483.

70. Gunaseelan R, Anantanarayanan P, Veerabahu M, Vikraman B. 2007; Simultaneous genial distraction and interposition arthroplasty for management of sleep apnoea associated with temporomandibular joint ankylosis. Int J Oral Maxillofac Surg. 36:845–8. https://doi.org/10.1016/j.ijom.2007.05.004 . DOI: 10.1016/j.ijom.2007.05.004. PMID: 17614256.

71. Li KK, Powell NB, Riley RW, Guilleminault C. 2002; Distraction osteogenesis in adult obstructive sleep apnea surgery: a preliminary report. J Oral Maxillofac Surg. 60:6–10. https://doi.org/10.1053/joms.2002.29049 . DOI: 10.1053/joms.2002.29049. PMID: 11756997.

72. Feiyun P, Wei L, Jun C, Xin X, Zhuojin S, Fengguo Y. 2010; Simultaneous correction of bilateral temporomandibular joint ankylosis with mandibular micrognathia using internal distraction osteogenesis and 3-dimensional craniomaxillofacial models. J Oral Maxillofac Surg. 68:571–7. https://doi.org/10.1016/j.joms.2009.07.022 . DOI: 10.1016/j.joms.2009.07.022. PMID: 19954874.

73. Miloro M. 2010; Mandibular distraction osteogenesis for pediatric airway management. J Oral Maxillofac Surg. 68:1512–23. https://doi.org/10.1016/j.joms.2009.09.099 . DOI: 10.1016/j.joms.2009.09.099. PMID: 20417010.

74. Jia W, He Y, Helal H, Wang Y, Li J. 2019; One-stage technique for treatment of ankylosis of the temporomandibular joint, secondary micrognathia, and a prominent mandibular angle. Br J Oral Maxillofac Surg. 57:701–3. https://doi.org/10.1016/j.bjoms.2019.05.022 . DOI: 10.1016/j.bjoms.2019.05.022. PMID: 31202512.

75. Srivastava D, Luthra P, Mishra S, Chandra L, Sharma S, Singh H. 2019; Technique of dual distraction for correction of unilateral temporomandibular joint ankylosis with facial asymmetry: a case series. J Oral Maxillofac Surg. 77:2555.e1–12. https://doi.org/10.1016/j.joms.2019.07.017 . DOI: 10.1016/j.joms.2019.07.017. PMID: 31473107.

76. Yadav R, Bhutia O, Shukla G, Roychoudhury A. 2014; Distraction osteogenesis for management of obstructive sleep apnoea in temporomandibular joint ankylosis patients before the release of joint. J Craniomaxillofac Surg. 42:588–94. https://doi.org/10.1016/j.jcms.2013.07.031 . DOI: 10.1016/j.jcms.2013.07.031. PMID: 24529347.

77. Zhu S, Wang D, Yin Q, Hu J. 2013; Treatment guidelines for temporomandibular joint ankylosis with secondary dentofacial deformities in adults. J Craniomaxillofac Surg. 41:e117–27. https://doi.org/10.1016/j.jcms.2012.11.038 . DOI: 10.1016/j.jcms.2012.11.038. PMID: 23321052.

78. Gonçalves JR, Gomes LC, Vianna AP, Rodrigues DB, Gonçalves DA, Wolford LM. 2013; Airway space changes after maxillomandibular counterclockwise rotation and mandibular advancement with TMJ Concepts® total joint prostheses: three-dimensional assessment. Int J Oral Maxillofac Surg. 42:1014–22. https://doi.org/10.1016/j.ijom.2013.04.009 . DOI: 10.1016/j.ijom.2013.04.009. PMID: 23726273.

79. Coleta KE, Wolford LM, Gonçalves JR, Pinto Ados S, Cassano DS, Gonçalves DA. 2009; Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part II--airway changes and stability. Int J Oral Maxillofac Surg. 38:228–35. https://doi.org/10.1016/j.ijom.2008.11.021 . DOI: 10.1016/j.ijom.2008.11.021. PMID: 19135866.