Treatment of temporomandybular ankylosis
INTRODUCTION: Ankylosis of the temporomandibular joint (TMJ) is called bone fusion or fibrous adhesion between anatomical structures that comprise it. this leads the patient to present limited mandibular movements. The main objective of the treatment of this pathology is to return the mandibular function to the patient, but, it is worth emphasizing the importance of restoring aesthetics, promoting ideal occlusion and preventing recurrences. For this, the correct diagnosis is essential, based on the clinical evaluation, in which the mouth opening limitation is observed, and through complementary exams. Thus, due to the importance of this treatment, it is essential that researches are carried out in order to update the management of patients' therapy. AIM: To raise knowledge about the current treatment of ankylosis of the ATM. MATERIAL AND METHODS: It is a qualitative study, with a revisionary nature of bibliographic references (n = 16). It was done using the descriptors: Temporomandibular Ankylosis, Joint Disorders and Treatment, and filtered by: articles published between 2016 and 2020; the written language, Portuguese and English and only articles that talk about humans were inserted. RESULTS: The treatment of TMJ ankylosis should be based on the reproduction of a joint that works in the required way, with the ability to adapt to functional changes and the ability to repair. Early surgery and physiotherapy can largely restore joint function. One of the surgeries is based on the complete removal of the ankylotic block, gap arthroplasty and ipsilateral coronoidectomy. In case of recurrent ankylosis, gap arthroplasty is recommended. In addition, it should be considered for the repair of primary ankylosis in pediatric patients, with an emphasis on postoperative physiotherapy to prevent recurrent ankylosis. Other surgical interventions are based on ankylosis release and arthroplasty using a temporal myofascial flap and costochondral graft. Still, studies do not recommend the use of aggressive physiotherapy, because underdeveloped tissues, muscles and ligaments are resistant to excessive opening. Thus, this causes pain at the opening of the mouth, which makes it difficult for patients to cooperate. Vigorous physical therapy also interferes with the "taking" of the grafted costochondral system. Physiotherapy tolerated by patients includes daily jaw movements while eating. CONCLUSION: The treatment for ankylosis of the TMJ is basically surgical, and can be done in several ways. In all post-surgical processes, the use of light physiotherapy is recommended, following the physiological movements of chewing. In addition, further research is needed to update the treatment of this disease and improve the healing process and prognosis of patients.
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