jaw growth after joint fusion treatment

Active, not recruiting

Conditions: Temporomandibular joint ankylosis

Registration Number: CTRI/2020/10/028475

Lead Sponsor: Indian Council of Medical Research

Brief Summary: Temporomandibularjoint (TMJ) ankylosis is a problem peculiar to India and Indian subcontinent.The patient develops many subsequent problems like nutritional deficit,aesthetic deformity due to interruption of growth and obstructive sleep apneasyndrome.

Thetreatment is release of ankylosis with creation of Gap or interposition ofvarious autogenous or alloplastic materials. The loss of condylar cartilage,which is thought to be a growth center, is said to cause the cessation ofmandibular growth in subsequent growing period in children who are operated ingrowing period. This results in asymmetry, retrognathia and sometimes problemsof obstructive sleep apnea.

Thereare conflicting views whether the condyle is primary growth center or is thematrix of muscle around mandible, which again becomes functional after releaseinduces growth. The functional matrix theory is well known. This confusion hasled to growth center transplantation in the released condyle by eithercostochondral joint ( CCG) or sternoclavicular joint.

Theaim of the study is to scientifically document the growth of mandible after releaseof TMJ ankylosis. The Gap arthroplasty proponents believe that the growth ofmandible after release of ankylosis can catch up as a result of muscle matrixbeing functional again and the growth center transplantation school bases itsassumptions on the condylar growth center theory.

Therehas never been any study on actual quantification of growth after Gap orcostochondral (CCG) interposition arthroplasty. The growth reporting haslargely been based on personal observations from case reports/ series. Therehave been conflicting reports in the literature about both and none have shownpredictable growth.

Theproposed research work will test the CCG arthroplasty and gap arthroplasty in asuperiority trial and will help obtaining level-I evidence for growth center transplantationrequirements in TMJ ankylosis. This will also establish which procedure hasless recurrence associated with it.

Detailed Description: Not available

Recruitment & Eligibility

Status: Closed to Recruitment of Participants

Sex: All

Target Recruitment: 70

Inclusion Criteria

patients with unilateral or bilateral temporomandibular joint ankylosis.

Exclusion Criteria

Recurrent ankylosis 2.
Ankylosis due to systemic conditions like rheumatoid arthritis 3.
Age >12 years 4.
Patients with obstructive sleep apnea syndrome 5.
Patients refusing consent for follow up.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
growth in joints with costochondral graft interposition arthroplasty for significant superiority over adequate growth in joints with gap arthroplasty treatment	Primary outcome will be assessed by radiographs taken at different follow-up (immediately postoperative, at 1 month, 6 month, 12-months and yearly thereafter). Panoramic radiograph will be taken to observe for heterotopic bone formation.

Secondary Outcome Measures

Name	Time	Method
functional outcomes of gap arthroplasty in the management of temporomandibular ankylosis.	evaluate the functional outcomes of interposition arthroplasty with costochondral graft in the management of temporomandibular ankylosis.

Trial Locations

Locations (1): All India Institute of Medical Sciences
🇮🇳
South, DELHI, India
All India Institute of Medical Sciences
🇮🇳South, DELHI, India
Dr Ajoy Roychoudhury
Principal investigator
01126589303
ajoyroy@hotmail.com