Category: Oral Pathology

ANKYLOSIS OF TMJ (HYPOMOBILITY)

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Image Source: @BMC Pediatrics

🔹 Etiology:

➡️ Proposed by Straith & Lewis:-

  1. Abnormal intrauterine development
  2. Birth injury (by forceps)
  3. Trauma to chin
  4. Mal-union of condylar fractures
  5. Congenital syphylis
  6. Primary inflammation of joint
  7. Inflammation secondary to blood stream infection
  8. Metastatic malignancy
  9. Fractures of the malar–zygomatic compound
  10. Loss of tissues with scarring
  11. Radiation therapy

🔹 Clinical Features:

  • Age: <10 years
  • M=F
  • Signs & Symptoms:
  1. Difficulty in opening mouth to any appreciable extent
  2. If complete fusion – absolute limitation of motion
  3. Facial deformity

🔹 Radiographic Features: – Abnormal or irregular shape of the head of the condyle & a radiopacity indicative of dense bone filling the joint space.

🔹 Treatment:

  • Surgical
  • Osteotomy: Removal of section of bone below the condyle
  • Fibrous Ankylosis: Functional methods

Dr. Mehnaz Memon🖊

References: Shafers Textbook Of Oral Pathology 7Ed

DEVELOPMENTAL DISORDERS OF TMJ

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🔹 Classification:-

1) Condylar Hypoplasia/Aplasia –

Clinical Features

1) Unilateral involvement (most common)

  • Defective/absent external ear
  • Underdeveloped ramus
  • Facial asymmetry
  • Altered occlusion & mastication
  • Lack of downward & forward growth of the body of mandible
  • Thickening of bone- Angle of mandible
  • Shift of mandible towards the affected side.

2) Bilateral involvement:

  • Micrognathia
  • Dental crowding
  • Open bite

Severe Cases

  • Airway obstruction
  • Posterior displacement of tongue
  • Feeding and speech error

Treatment

  1. Cartilage/Bone transplants – Osteotomy
  2. Tracheostomy – Airway obstruction
  3. Severe cases – Osteoplasty

2) Condylar Hyperplasia:-

➡️ Enlargement due to chronic inflammation.

CATEGORIES

Clinical Features

  1. Age – 3rd decades; Sex – Females
  2. Elongation of face
  3. Deviation of chin away from the affected side.
  4. O/M: Malocclusion

Treatment

  1. Condylectomy
  2. Orthodontics
  3. Orthognathic Surgery

3) Bifid Condyle:-

➡️ A deep groove/depression around midline of condylar head due to lack of blood supply or trauma. Asymptomatic in nature.

Dr. Mehnaz Memon🖊

References: Shafers Textbook Of Oral Pathology 7Ed, Image Source: Google