Alloplastic total joint reconstruction for severe temporomandibular joint ankylosis in the skeletally immature patient: a narrative review

Background and Objective: Temporomandibular joint (TMJ) ankylosis has a severe impact on function and growth. Several treatments have been proposed with limited success and significant morbidity. In the growing patient, alloplastic TMJ reconstruction (TMJR) is usually reserved as the last resource. The purpose of this article was to perform a narrative review to access the feasibility of treating ankylosis in the growing patients with alloplastic implants. Methods: A comprehensive electronic search was conducted on MEDLINE/PubMed, up to Jun 15, 2022. Medical subject heading terms (MeSH) and free-text words were used in the electronic database searches to find articles that reported: Temporomandibular Joint; OR Temporomandibular AND Joint AND Ankylosis; OR Ankylosis AND Joint Prosthesis; OR Joint AND Prosthesis; OR Alloplastic. The primary outcome was to find how many cases have been reported involving the treatment of ankylosis in the skeletally immature patient with alloplastic TMJR. Any study that reported the use of these devices to treat ankylosis in patients at age 16 or younger was included. Key Content and Findings: Two hundred and eighty-eight potential studies were identified for titles and abstracts, and 48 studies were included for full-text reading. Fifteen articles were found with at least 1 report of skeletally immature patients with ankylosis treated with alloplastic TMJR. Conclusions: Alloplastic TMJR is a good treatment option in growing patients with ankylois that have failed conventional treatment such as gap arthroplasty (GA) and grafts, but it may also be considered as a first line treatment.