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Introduction <p>: Temporomandibular joint (TMJ) ankylosis causes significant functional and developmental impairments. Traditional treatments often result in complications such as open bite, morbidity, and unpredictable outcomes. Lateral arthroplasty with abdominal dermal fat graft (ADFG) offers a minimally invasive solution for He and Yang Type A2 and A3 TMJ ankylosis, preserving joint structure while promoting jaw mobility and growth.</p> Methods <p>This study included 40 patients aged 3–37 years, diagnosed with Type 3 TMJ ankylosis (Shawney’s classification) and A2 &amp; A3 (He et al.). Lateral arthroplasty with ADFG was performed under general anesthesia. Clinical parameters assessed included maximum interincisal mouth opening (MIMO), excursive movements, occlusion, pain (VAS), and radiographic measurements of ramus-condyle angle and ramal height. Follow-up ranged from 6 months to 4 years (average 2.5 years).</p> Results <p>Preoperatively, the mean MIMO was 8.22&#xa0;mm, improving to 35.9&#xa0;mm at final follow-up. Significant improvements in excursive and protrusive movements were observed. Occlusion remained stable in most patients, with two developing a contralateral open bite, managed with elastics. The mean condyle-ramus angle increased from 145.88° to 158.8°. Transient facial paresis occurred in 35%, resolving with TENS therapy. Postoperative complications included infection (5%) managed with local debridement and irrigation and jaw deviation (15%). Ramal height was preserved in all patients, with a reankylosis rate of 2.5%.</p> Conclusion <p>Lateral arthroplasty with ADFG is an effective, minimally invasive approach for Type 3 TMJ ankylosis, restoring function, enabling growth, and improving esthetics without requiring ramus condyle unit reconstruction.</p>

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From Rigidity of a Closed Jaw to the Freedom of Movements: Lateral Arthroplasty with ADFG as a Minimally Invasive Alternative for He and Yang Type A2 and A3 TMJ Ankylosis

  • 期刊论文

  • 发表日期：

    2025年11月18日

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  • Shruti Morzaria,
  • Jigar Dhuvad,
  • Sonal Anchlia,
  • Ghanshyam Prajapati,
  • Srishti Sodhiya,
  • Villa Sai Srujana

摘要

Introduction

: Temporomandibular joint (TMJ) ankylosis causes significant functional and developmental impairments. Traditional treatments often result in complications such as open bite, morbidity, and unpredictable outcomes. Lateral arthroplasty with abdominal dermal fat graft (ADFG) offers a minimally invasive solution for He and Yang Type A2 and A3 TMJ ankylosis, preserving joint structure while promoting jaw mobility and growth.

Methods

This study included 40 patients aged 3–37 years, diagnosed with Type 3 TMJ ankylosis (Shawney’s classification) and A2 & A3 (He et al.). Lateral arthroplasty with ADFG was performed under general anesthesia. Clinical parameters assessed included maximum interincisal mouth opening (MIMO), excursive movements, occlusion, pain (VAS), and radiographic measurements of ramus-condyle angle and ramal height. Follow-up ranged from 6 months to 4 years (average 2.5 years).

Results

Preoperatively, the mean MIMO was 8.22 mm, improving to 35.9 mm at final follow-up. Significant improvements in excursive and protrusive movements were observed. Occlusion remained stable in most patients, with two developing a contralateral open bite, managed with elastics. The mean condyle-ramus angle increased from 145.88° to 158.8°. Transient facial paresis occurred in 35%, resolving with TENS therapy. Postoperative complications included infection (5%) managed with local debridement and irrigation and jaw deviation (15%). Ramal height was preserved in all patients, with a reankylosis rate of 2.5%.

Conclusion

Lateral arthroplasty with ADFG is an effective, minimally invasive approach for Type 3 TMJ ankylosis, restoring function, enabling growth, and improving esthetics without requiring ramus condyle unit reconstruction.