TMJ ankylosis is stiffening or fusion of the jaw joint (temporomandibular joint), where the lower jaw becomes joined to the skull by bone or fibrous tissue, severely limiting mouth opening. It usually follows trauma or infection. Surgery removes the fused tissue and reconstructs the joint to restore mouth opening, eating and speech.
- AnaesthesiaGeneral
- DurationTypically 2 to 4 hours
- Hospital stayUsually a few days
- Back to routineSoft diet for several weeks; jaw exercises for months
What is tmj ankylosis correction?
In temporomandibular joint (TMJ) ankylosis, the lower jaw fuses to the base of the skull through bone or fibrous tissue. True (intra-articular) ankylosis involves the joint itself; false (extra-articular) ankylosis arises from structures outside the joint, such as an enlarged coronoid process, scarring or radiation. It is usually caused by trauma, joint infection or rheumatoid arthritis, and can be congenital.
Other causes include fractures of the zygomatic arch or condylar neck, surgery near the joint, inherited ankylosing conditions and cartilage destruction. When it occurs in childhood it can impair jaw growth: involvement of both sides can produce a small, receding chin ('bird face'), while one-sided involvement causes facial asymmetry.
Problems include restricted mouth opening and jaw movement, difficulty chewing, speaking, breathing and swallowing, sleep problems, dental decay and misaligned teeth, and emotional and social effects. Treatment aims to restore jaw function, correct facial deformity, reduce pain and prevent re-fusion.
Who is tmj ankylosis correction for?
- Children and adults with severely restricted or no mouth opening
- Jaw stiffness following a jaw or chin injury, especially in childhood
- Ankylosis after ear or joint infection, or rheumatoid arthritis
- Facial asymmetry or a small, receding lower jaw from ankylosis
- Difficulty eating, speaking, maintaining oral hygiene, or breathing during sleep
How is it done?
- Gap arthroplasty: removal of the fused bony or fibrous mass to create a new joint space
- Interpositional arthroplasty with grafts or other material to reduce re-fusion
- Condylectomy or total condylectomy with joint reconstruction or replacement
- Coronoidectomy, myotomy or osteotomy where needed to free the jaw fully
- Before surgery: stop smoking (ideally at least 3 months before), avoid aspirin and anti-inflammatory medicines if advised, and prepare a small toothbrush or water flosser and supportive pillows
What is recovery like?
- A liquid diet initially, progressing to soft foods
- Regular, often long-term, jaw-opening exercises are essential to keep the mouth open and prevent re-fusion
- Ice packs on the side of the face reduce swelling
- Keep the surgical site dry while showering and change dressings as advised, with antibiotic ointment
- Avoid tea, coffee, sodas and chocolate in the early period, as advised on the existing page
What are the risks?
- Re-ankylosis (the joint fusing again), especially if exercises are not continued
- Facial nerve weakness, usually temporary
- Bleeding, infection and swelling
- Changes in bite
- Anaesthesia and airway challenges because of restricted mouth opening
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
What causes TMJ ankylosis?
The most common cause is injury to the jaw joint, often a fall on the chin in childhood. Infection spreading to the joint, rheumatoid arthritis, previous surgery near the joint, and congenital or inherited conditions are other causes. Scarring or an enlarged coronoid process outside the joint can produce a similar 'false' ankylosis.
Can TMJ ankylosis be treated without surgery?
Established bony or fibrous fusion of the jaw joint does not respond to exercises or medicines alone. Surgery is needed to free the joint. Jaw exercises are, however, essential after surgery to maintain the improved mouth opening and lower the risk of the joint fusing again.
Why are jaw exercises so important after surgery?
The joint tends to stiffen again as it heals. Regular jaw-opening exercises, often for many months, keep the new joint space moving and help prevent re-ankylosis. Stopping exercises too early is one of the main reasons the problem can return.
Does TMJ ankylosis affect facial growth in children?
Yes. The jaw joint is an important growth centre for the lower jaw. Ankylosis in childhood can lead to a small, receding chin when both sides are affected, or a lopsided face when one side is affected. Additional jaw surgery may be needed later to correct the deformity.
