[Anatomic and physiopathological basis for the surgical treatment of temporomandibular ankylosis].

Lack of application of anatomical and physiopathological features leads to incomplete results following wide resection of an ankylosed bone block, the use of an intra-articular interposition with the single objective of interfering with postoperative synostosis, forced mobilization with the open mouth, and complementary surgical acts to improve esthetic results only. These results can be transformed by ensuring good postoperative functional dental occlusion and adequate functioning of the lateral meniscopterygoid-condylar apophysis system, but this is not always possible. When this system (mobilizer of the mandible) is not recoverable, other means of mandibular mobilization must be attempted, particularly a good muscular interposition, mechanotherapy in propulsion and retropulsion, and early sufficient lengthening of the ascending mandibular rami. Early surgery is always beneficial in children as it reduces constraints which limit growth and lowering of the body of the mandible. One of the most important steps in the progress of this surgery is the procedure for lengthening the condylar segment (after freeing or resection of the ankylosed condyle), and the use of a chondrocostal graft. Care must be taken in all cases to restore good occlusal function, the best means of improving articular function and the persistence of a good buccal opening.