110 International Journal of Drug Research and Dental Science International Journal of Drug Research and Dental Science Volume 2 Issue 4 (Page: 110-116), 2020 ISSN: 2582-0826 Keywords: Gap Arthroplasty, TMJ Ankylosis, Pre Auricular, Al Kayat Bramley, Coronoidectomy. Gap Arthroplasty: Surgical Modality of TMJ Ankylosis Shishir Dhar 1 , Shubhamoy Mondal 2 , Sumit Verma 3 , Anshul Sawhney 4* 1 Assistant Professor, Department of Dentistry/Oral & Maxillofacial Surgery, Government Medical College, Saharanpur, UP. India. 2 Reader, Department of Oral & Maxillofacial Surgery, Sardar Patel Post Graduate Institute of Dental & Medical Sciences, Lucknow, UP, India. 3 Reader, Department of Oral & Maxillofacial Surgery, Awadh Dental College & Hospital, Jamshedpur, Jharkhand, India. 4 Assistant Professor, Department of Dentistry, Autonomous State Medical College, Bahraich, UP, India. Case Report Address for Correspondence Author Dr. Anshul Sawhney; Department of Dentistry, Autonomous State Medical College, Bahraich, UP, India. E‑mail: balboashishir@gmail.com Crossref doi: https://doi.org/10.36437/ijdrd.2020.2.4.O ABSTRACT This report describes surgical management of a 13-year-old female with unilateral TMJ (true) bony ankylosis with restricted IIO of 2mm, mandibular retrognathism, difficulty in speech, eating & breathing, along low self- confidence. Unilateral gap arthroplasty through a preauricular approach with ipsilateral coronoidectomy was done followed by aggressive jaw physiotherapy. Post surgically oral prophylaxis, restoration, extraction of carious teeth along speech therapy & psychological counselling were also done to enhance function & boost self-esteem & confidence ultimately resulting in good mouth opening, removing impaired functions & psychological stigma. Introduction Ankylosis of TMJ is described as an intracapsular fusion of the disc-condyle complex to articular surface of temporal bone including the fibrous/bony fusion between disc, condyle, glenoid fossa & articular eminence thus restricting the mandibular movements. 1 This fusion severely restricts the jaw movements & its growth, especially if it develops during the growth period of the patient. This disabling condition not only causes facial deformities, speech impairment, difficulty in mastication, reduction in airway space but is also psychologically distressing for the patient. 2 Trauma to TMJ (13-100%), local / systemic infections(10-49%), or systemic diseases(100%), like rheumatoid arthritis, ankylosing spondylitis & psoriasis chiefly comprise etiology of TMJ ankylosis. 3 TMJ ankylosis is classified by a combination of location ( intra or extra articulation), based on tissues involved (fibrous, bony, or