Technique of dual distraction for correction of unilateral temporomandibular joint ankylosis with facial asymmetry: A case report

Joint arthroplasty coupled with distraction osteogenesis is an attractive treatment option for correction of TMJ ankylosis associated with secondary mandibular deformity. Lately, advances in surgical techniques and equipment have greatly widened the horizon for application of distraction osteogenesis in correction of skeletal deformities. Despite the availability of several surgical techniques, treatments still continue to be challenging. Search for a technique that will reduce the frequency of complications while providing more predictable outcomes is still continuing. In the case report described here, interpositional gap arthroplasty using temporomyofascial flap and extra-oral distraction osteogenesis were combined in a single surgical operation to treat a young adult for unilateral TMJ ankylosis with mandibular deficiency. A modified distraction technique was employed wherein two extra-oral distractors were placed on the affected side to provide more effective and predictable distraction. Marked improvement in aesthetics, function and occlusion could be appreciated with the use of this modified technique.