img_20200815_1151402-7836464

CLASSIFICATION:

1. Based on type of tissue causing Ankylosis:

img_20200815_123219-4912949 img_20200815_123222-1-6350779

2. Based on the Side Involved :

tmj-ankylosis-8019831 denthypotheses_2014_5_3_103_136754_f6-1641571

3. Based on Severity of Ankylosis:

4. Based on Etiology of Trismus:

  • Pseudo Ankylosis
  • True Ankylosis

SAWHNEY’S CLASSIFICATION:

schematic-diagram-of-sawhneys-classification-of-temporomandibular-joint-ankylosis2-9076244 Grading of Ankylosis in Children

CLINICAL FEATURES:

img_20200815_1304332-8239894 img_20200815_1305562-9318821

INVESTIGATIONS:

1. Radiographs:

– OPG

jfmpc-5-716-g002-2906551 OPG: *Helps in bilateral comparison of the joint.**The antigonial notch can be appreciated in this type of radiograph.

-PA VIEW:

f000274f027-010-97803230963312-5397393 PA View:Medio-lateral extent of bony growth can be seen on this radiograph.

– Lateral Oblique View of Mandible:

Ankylotic mass can seen in the Anteroposterior direction.

2. Lateral Cephalogram:

pre-treatment-lateral-cephalogram-of-21-year-old-male-with-severe-mandibular-hypoplasia-8564573 Periodic radiographs taken can help to estimate growth of the jaw.

3. CT Scan:

Helpful as it gives an accurate picture of proximity of ankylotic mass to important structure,that cannot be seen in a radiograph.

1982-0216-rcefac-16-06-02053-gf7-7797270 CT Scan: Ankylosed TMJ

RADIOGRAPHIC FEATURES:

  • Decreased ramus height on the affected site.
  • Lack of joint space.
  • Normal joint space obliteration by bone/fibrous growth.
  • Elongation of coronoid process.
  • Deep antigonial notch.

REFERENCES:

  • Textbook of Oral & Maxillofacial Surgery, Chitra Chakravarthy (2nd Edition).
  • DentalHypothesis.com
  • Europe PMC
  • PocketDentistry.com
  • SciELO.com