TMJ Ankylosis and OSMF Mutual Cohabitants in Restricted Mouth Opening
Author(s): Sneha Krishnan, Muthusekhar MR, Senthilnathan Periasamy* and Murugaiyan Arun
Abstract
Temporomandibular joint ankylosis is defined as the fusion between two articular surfaces of the TMJ (condyle and glenoid fossa) by fibrous or bony tissue. Oral submucous fibrosis is an insidious chronic disease which leads to stiffness of the oral mucosa and causes trismus and inability to eat. The aim of this case report is to study a rare case of simultaneous occurrence of TMJ ankylosis and oral submucous fibrosis in the same patient. In this present case, the patient had presented with limited mouth opening, but the diagnosis of oral submucous fibrosis was overlooked in the first scenario. It was concluded that the patient had acquired OSMF before TMJ ankylosis, as fibrosis tends to set in earlier than bony fusion and due to noncompliance of jaw exercises one condition aggravated and led to formation of another. This case was treated with release of the TMJ Ankylosis and the surgical created defect was filled with interpositional dermis fat graft. Following this fibrotomy was performed intraorally to relieve the fibrous bands and a split skin graft prepared over a polyethylene stent was placed over the raw wound area. Patient was advised aggressive physiotherapy post-surgery, as both conditions were present as mutual cohabitants resulting in restricted mouth opening.