Interpositional arthroplasty with temporal muscle flap-a surgical alternative for condylar ankylosis of the temporomandibular joint

Ankylosis of the temporomandibular joint (TMJ) is characterized by a bony or fibrous fusion between the articular fossa and the condyle. It represents one of the greatest therapeutic challenges in oral and maxillofacial surgery. Several treatments have been used for its ma-nagement, such as gap arthroplasty, interpositional arthroplasty, and TMJ reconstruction with autogenous bone graft and alloplastic prostheses. A 39-year-old Black male patient developed a complex mandibular symphysis fracture associated with bilateral high condy-lar fractures after a motorcycle accident. In the first approach, osteosynthesis was performed to reduce and fix symphysis fractures and conservatively treat the condyles. However, the patient did not proceed with physiotherapy and adequate follow-up, evolving into bilateral ankylosis. Subsequently, he underwent interpositional arthroplasty with a temporal muscle flap. The treatment of ankylosis is imperatively surgical and aims to release the joint and reanatomize the region, restoring functionality to the stomatognathic system. The choice of technique depends on many factors, including age. In children, gap arthroplasty is the most frequent choice because it helps in the centrality of condylar growth. In adult patients, gap arthroplasty with interposition of the temporal muscle is eligible, as it restores function and reduces the recurrence of bone fusion and consequent re-ankylosis. (Rev Port Estoma-tol Med Dent Cir Maxilofac. 2022;63(3):154-158)(c) 2022 Sociedade Portuguesa de Estomatologia e Medicina Dentaria. Publicado por SPEMD. Este e um artigo Open Access sob uma licenca CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).