Surgical correction without bone grafts of maxillofacial asymmetric deformities in patients treated for unilateral temporomandibular joint ankylosis.

Objective: With the inclusion criteria of patients confirmed and the therapeutic effects and stability evaluated, this article presents the clinical value of bimaxillary orthognathic surgery without bone graft of maxillofacial asymmetric deformities in patients treated for unilateral temporomandibular joint (TMJ) ankylosis.

Study Design: From 2008 to 2012, 12 patients with dentomaxillofacial asymmetric deformities secondary to unilateral TMJ ankylosis who had undergone TMJ reconstruction as the primary surgery were included in the study. Preoperatively, all patients had compensatory occlusal plane and maxillary inclination <10° and mandibular advancement <15 mm according to computer-assisted 3-dimensional surgical simulation and prediction. Patients received LeFort I osteotomy and bilateral sagittal split rami osteotomy without bone graft, and genioplasty. Pre- and postoperative and long-term radiographic examinations were done to evaluate the therapeutic effects.

Results: Maxillofacial asymmetry and abnormal occlusions in patients were clearly improved in the parameters of facial appearance and occlusion as recorded pre- and postoperatively and long term. All patients obtained satisfactory results and were stable in the 36- to 50-month follow-up period.

Conclusion: The bimaxillary orthognathic treatment protocol without bone grafts described in this study can provide stable improvement in facial appearance and occlusion of secondary dentomaxillofacial deformities in appropriate patients with unilateral TMJ ankylosis.