Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (12): 793-800.doi: 10.12016/j.issn.2096-1456.2021.12.001

• Expert Commentary • Previous Articles     Next Articles

New progress in the pathogenesis of traumatic temporomandibular joint ankylosis

HU Kaijin(),MA Zhen,WANG Yiming,DENG Tiange()   

  1. State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Air Force Medical University, Xi’an 710032, China
  • Received:2021-05-06 Revised:2021-06-15 Online:2021-12-20 Published:2021-08-17
  • Contact: Kaijin HU,Tiange DENG;
  • Supported by:
    National Natural Science Foundation of China(81970954)


Traumatic temporomandibular joint ankylosis refers to fibrous or bony fusion between the condyle and the glenoid fossa. It can cause problems with mouth-opening limitations, mastication difficulties, obstructive sleep apnea and hypopnea syndrome. When traumatic temporomandibular joint ankylosis occurs during childhood, it can cause facial asymmetry, micrognathia, and malocclusion, which significantly affect the physical and mental health. Once temporomandibular joint ankylosis occurs, it will be refractory and recurrent. The pathogenesis of temporomandibular joint ankylosis has not been completely elucidated and has always been a research hotspot in the oral and maxillofacial fields. In this paper, worldwide research was conducted, and the pathogenesis of traumatic temporomandibular joint ankylosis was clarified, such as “damage of condyle”,“disc displacement or rupture”,“damage to the glenoid fossa” and “lateral pterygoid muscle distraction”. The relative pathogenesis hypotheses were summarized, such as “hematoma organization” and “lateral pterygoid muscle distraction osteogenesis”. The related pathogenesis of traumatic temporomandibular joint ankylosis was discussed based on the latest cytology and molecular biology research.

Key words: trauma, temporomandibular joint, ankylosis, pathogenesis, mandibular condyle, articular disc, glenoid fossa, lateral pterygoid muscle, animal model, mesenchymal stem cells, macrophages

CLC Number: 

  • R78

Figure 1

Pathogenesis of temporomandibular joint ankylosis"

[1] Acri TM, Shin K, Seol D, et al. Tissue engineering for the temporomandibular joint[J]. Adv Healthc Mater, 2019, 8(2):e1801236. doi: 10.1002/adhm.201801236.
[2] Deng TG, Liu CK, Wu LG, et al. Association between maximum mouth opening and area of bony fusion in simulated temporomandibular joint bony ankylosis[J]. Int J Oral Maxillofac Surg, 2020, 49(3):369-376. doi: 10.1016/j.ijom.2019.06.030.
doi: 10.1016/j.ijom.2019.06.030
[3] Meng F, Liu Y, Hu K, et al. A comparative study of the skeletal morphology of the temporo-mandibular joint of children and adults[J]. J Postgrad Med, 2008, 54(3):191-194. doi: 10.4103/0022-3859.40960.
pmid: 18626165
[4] Chouinard AF, Kaban LB, Peacock ZS. Acquired abnormalities of the temporomandibular joint[J]. Oral Maxillofac Surg Clin North Am, 2018, 30(1):83-96. doi: 10.1016/j.coms.2017.08.005.
doi: 10.1016/j.coms.2017.08.005
[5] Resnick CM. Temporomandibular joint reconstruction in the growing child[J]. Oral Maxillofac Surg Clin North Am, 2018, 30(1):109-121. doi: 10.1016/j.coms.2017.08.006.
doi: 10.1016/j.coms.2017.08.006
[6] Agarwal B, Yadav P, Roychoudhury A, et al. Does bilateral gap arthroplasty increase the severity of obstructive sleep apnea in patients with temporomandibular joint ankylosis?[J]. J Oral Maxillofac Surg, 2021, 79(6):1344. doi: 10.1016/j.joms.2021.01.015.
[7] Yan YB, Zhang Y, Gan YH, et al. Surgical induction of TMJ bony ankylosis in growing sheep and the role of injury severity of the glenoid fossa on the development of bony ankylosis[J]. J Craniomaxillofac Surg, 2013, 41(6):476-486. doi: 10.1016/j.jcms.2012. 03.011.
doi: 10.1016/j.jcms.2012.03.011
[8] De Roo N, Van Doorne L, Troch A, et al. Quantifying the outcome of surgical treatment of temporomandibular joint ankylosis: a systematic review and meta-analysis[J]. J Craniomaxillofac Surg, 2016, 44(1):6-15. doi: 10.1016/j.jcms.2015.08.019.
doi: 10.1016/j.jcms.2015.08.019
[9] Bathi RJ, Taneja N, Parveen S. Rheumatoid arthritis of TMJ--a diagnostic dilemma?[J]. Dent Update, 2004, 31(3):167-170. doi: 10.12968/denu.2004.31.3.167.
doi: 10.12968/denu.2004.31.3.167
[10] Galié M, Candotto V, Elia G, et al. Temporomandibular joint ankylosis after early mandibular distraction osteogenesis: a new syndrome?[J]. J Craniofac Surg, 2017, 28(5):1185-1190. doi: 10.1097/SCS.0000000000003612.
doi: 10.1097/SCS.0000000000003612
[11] Movahed R, Mercuri LG. Management of temporomandibular joint ankylosis[J]. Oral Maxillofac Surg Clin North Am, 2015, 27(1):27-35. doi: 10.1016/j.coms.2014.09.003.
doi: 10.1016/j.coms.2014.09.003
[12] Valentini V, Vetrano S, Agrillo A, et al. Surgical treatment of TMJ ankylosis: our experience (60 cases)[J]. J Craniofac Surg, 2002, 13(1):59-67. doi: 10.1097/00001665-200201000-00013.
doi: 10.1097/00001665-200201000-00013
[13] Ma D, Zhang S, Pang C, et al. The Application of intraoperative computed tomography in surgical management of temporomandibular joint ankylosis[J]. J Oral Maxillofac Surg, 2021, 79(1): 90.e1-90.e7. doi: 10.1016/j.joms.2020.09.002.
doi: 10.1016/j.joms.2020.09.002
[14] Xia L, Zhang Y, An J, et al. Evaluating the remodeling of condyles reconstructed by transport distraction osteogenesis in the treatment of temporomandibular joint ankylosis[J]. J Craniomaxillofac Surg, 2020, 48(5):494-500. doi: 10.1016/j.jcms.2020.03.004.
doi: 10.1016/j.jcms.2020.03.004
[15] Xia L, He Y, An J, et al. Condyle-preserved arthroplasty versus costochondral grafting in paediatric temporomandibular joint ankylosis: a retrospective investigation[J]. Int J Oral Maxillofac Surg, 2019, 48(4):526-533. doi: 10.1016/j.ijom.2018.07.018.
doi: 10.1016/j.