Role of sternoclavicular graft for joint reconstruction in unilateral temporomandibular joint ankylosis - a prospective study

BACKGROUND: TMJ ankylosis is one of the most physically incapacitating and psychologically distressing conditions of the TMJ. Various treatment modalities have been proposed for treatment of TMJ ankylosis each having its own merits and demerits. The most favoured autogenous graft has long been the costochondral graft for reconstruction of ramus condyle unit but the unpredictable growth pattern of the CCG has made us to search for a better alternative. Literature revealed that the sternoclavicular joint resembled the TMJ morphologically and histologically. AIM AND OBJECTIVES: To evaluate the feasibility of using sternoclavicular graft for TMJ reconstruction in TMJ ankylosis and to also assess this technique in restoration of mandibular movement and function and growth of the mandible METHODS: Five patients with unilateral ankylosis were included in this prospective study. All patients underwent TMJ ankylosis release and reconstruction of the joint with Sternoclavicular joint. OBSERVATION & RESULTS: Our results revealed that there was anatomic resemblance of the sternoclavicular graft to the TMJ and there was no donor site morbidity as there was regeneration of clavicle at the donor site.The mouth opening was normal (more than 30mm) in all the cases during the follow up period after the reconstruction of the TMJ with SCG. Moreover the patients were subjectively satisfied with the outcome of the results. It is important to note that the psychological inhibition which was present before surgery is entirely alleviated INTERPRETATION AND CONCLUSION: Within the limitations of this study, it was concluded that Sternoclavicular Joint could be a reliable and versatile alternative for reconstruction of TMJ