485: Temporomandibular Joint Ankylosis: A Prospective Study with Focus on Evaluating Treatment Outcomes

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary orofacial pain, Assessment and Measurement of Pain/Nociception

Background and Aims: Temporomandibular joint disorders (TMDs) are a common type of orofacial pain, affecting approximately 15-20% of the population. Patients who experience unsuccessful treatments through non-surgical methods, may have surgical intervention performed. TMDs such as temporomandibular joint (TMJ) ankylosis and heterotopic ossification can be managed with arthroplasty supplemented by an abdominal fat-transplant. Such surgeries have an overall success rate of approximately 80%. Factors predisposing to surgical failure have yet to be adequately investigated. Therefore, the aim of this study is to evaluate the impact on treatment outcomes, measuring pain intensity, function and quality of life in this multicenter project in Norway.

Methods: This prospective study includes patients from the Bergen cohort undergoing arthroplasty for TMJ ankylosis. Patient-reported outcomes on pain, function, and quality of life were evaluated using VAS-pain scores (0-10), maximum incisor opening (MIO, mm) measurements, and the questionnaires: Oral Impact on Daily Performance and Oral Health Impact Profile. Criteria for surgical success were defined as postoperative MIO of at least 35mm or 40% improvement and a postoperative pain intensity no higher than VAS 3 or 40% improvement, and no reoperation. A weak surgical success is right at the limits of success, while strong success is over the defined success margins.

Results: Patient inclusion is ongoing; however, preliminary results have been assessed for the patient group collected so far. The mean VAS-pain score was 5.50 in contrast to 2.25 postoperatively. Mean MIO measurements improved from 23.25mm (34.75mm assisted) preoperatively to 34.25mm (36,75mm assisted) postoperatively. Hence, out of the patients included in the prospective group so far, all patients achieved surgical success with roughly half the patients being regarded as having strong surgical successes, and the other half, weak surgical success. Results from the questionnaires are yet to be collected; however, preliminary results will be presented at the conference.

Conclusions: Thus far, all patients have achieved a postoperative VAS-pain score of less than or equal to 3 (or a 40% improvement from preoperative value), in addition to a postoperative MIO of at least 35mm (or a 40% improvement from preoperative value), and there were no reoperations, leading to all patients being categorized as surgical successes (some weak successes and some strong successes).

References: Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, et al. Factors involved in the etiology of temporomandibular disorders - a literature review. Clujul Med [Internet]. 2015;88(4):473–8

Lund B, Ulmner M, Bjørnland T, Berge T, Olsen-Bergem H, Rosèn A. A disease focused view on the temporomandibular joint: a Delphi process guided classification. Journal of Oral Science, Vol. 62, No. 1, 1-8, 2020.

Sweeney K, Handa S, August M, Keith DA. Are There Identifiable Risk Factors Associated With Heterotopic Ossification of the Temporomandibular Joint? J Oral Maxillofac Surg. 2022 Aug;80(8):1318-1330. doi: 10.1016/j.joms.2022.04.020. Epub 2022 May 2. PMID: 35636473.

Keith DA, Handa S, Mercuri LG. Peri-articular bone formation involving the temporomandibular joint: a narrative summary and Delphi consensus of a new classification system. Int J Oral Maxillofac Surg. 2024 Mar;53(3):212-218. doi: 10.1016/j.ijom.2023.09.003. Epub 2023 Sep 28. PMID: 37777385.

Presenting Author: Lina Saleh
Submitting Author: Lina Saleh

Senior Author: Annika Rosen

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Jenny Rajkumar: Research student - Department of Clinical Dentistry, University of Bergen, Bergen, Norway and Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway
• Torbjørn Pedersen: Associated professor - Department of Clinical Dentistry, University of Bergen, Bergen, Norway and Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
• Saeedeh Bagheri Helland: Oral surgeon - Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
• Kathrine Skarstein: Professor - Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, Bergen, Norway and Department of Pathology, Haukeland University Hospital, Bergen, Norway
• Annika Rosen: Professor - Department of Clinical Dentistry, University of Bergen, Bergen, Norway and Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway