TMJ replacement surgery performed successfully

Mangaluru: KMC Hospital has successfully performed a dentofacial deformity procedure correction for TMJ ankylosis via total temporomandibular joint (TMJ) replacement, on a 10-year-old patient.
Master Philip (name changed) had a previous history of multiple surgeries, following diagnosis of ankylosis with various modalities. For the child, the medical condition had started 10 days postnatal, in the form of a parotid abscess, and had progressed to the current condition of ankylosis. The full spectrum of treatment by way of multiple surgeries, involved the use of ribs to promote growth in the lower jaw, creating a gap after the removal of bone at the level of joint, and interposing muscle to prevent refusion. In addition to the above manoeuvres, the child was also subjected to the principles of bone lengthening using distraction osteogenesis, which stems from the principles of orthopaedics by Ilizarov, said Dr Abhay T Kamath, consultant oral and maxillofacial surgeon.
“The child was diagnosed with MRSA (methicilin-resistant staphylococcus aureus) during the previous surgeries. It was more essential to treat MRSA and plan the surgery, which was a real challenge. After a thorough investigation, the parents were counselled regarding the role and use of alloplastic joint replacement, as the child had exhausted all other treatment modalities. The joints were shipped from Atlanta, Jacksonville, USA, customised for the child, which is referred to as patient-specific TMJ implants,” he said.
“Post operatively, we were able to achieve a mouth opening of 25mm, compared to the nil mouth opening,” he added.