Analysis of remodeling and degenerative changes in the condylar process on the contralateral side in children with unilateral ankylosis post-mandibular ramus distraction

Abstract

Relevance. Patients with a history of unilateral ankylosis of the temporomandibular joint (TMJ) exhibit significant functional and anatomical abnormalities, leading to diminished quality of life and social adaptation. This condition necessitates a complex, multi-stage rehabilitation process. The contralateral, non-operated joint often bears the brunt of functional loads for an extended period post-surgery. Frequently, due to ankylosis-related interventions such as distraction osteogenesis and osteoplasty using various biomaterials, as well as orthognathic surgery, the bone structure of the contralateral joint is subjected to loads exceeding their biological capacity, resulting in notable degenerative changes around the condylar process head.Materials and methods. An analysis was conducted on data from 55 patients who, within the age range of 7 to 18 years, had undergone multiple mandibular ramus distraction osteogenesis surgeries due to a history of unilateral ankylosis.Results. The application of the distraction apparatus led to rotational movements of the mandible within the coronal plane, thereby increasing compression around the TMJ on the contralateral side. Subsequent degenerative alterations in the area of the condylar head were observed in 61.8% of the patients.Conclusion. To mitigate the risk of degenerative changes in the contralateral condylar process head, it is advisable to utilize an orthopedic splint to separate the articular surfaces of the TMJ. This approach helps reduce pressure on the condylar process and prevents pathological remodeling.