Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency.
Ankylosis of the TMJ involves fusion of the mandibular condyle to the base of the skull. When it occurs in a child, it can have devastating effects on the future growth and development of the jaws and teeth. It also has a profoundly negative influence on the psychosocial development of the patient, because of the obvious facial deformity, which worsens with growth.
The most common etiological factors are trauma and infection. If the cause is trauma, it is hypothesized that intra-articular hematoma, along with scarring and formation of excessive bone, leads to the hypomobility. Infection of the TMJ most commonly occurs secondary to contiguous spread from otitis media or mastoiditis, but it may also result from hematogenous spread of infectious conditions such as tuberculosis, gonorrhea, or scarlet fever. Systemic causes of TMJ ankylosis include ankylosing spondylitis, rheumatoid arthritis, and psoriasis
Treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function.
Immediate surgery or management is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of the child.