DIAGNOSTIC CRITERIA FOR TEMPOROMANDIBULAR JOINT ANKYLOSIS

Abstract

Introduction: Temporomandibular joint (TMJ) ankylosis is a pathological condition characterized by fibrous or bony fusion between the mandibular condyle and the base of the skull, occurring in both adults and children, resulting in functional and aesthetic limitations as well as psychosocial impairment. Its etiology is commonly related to trauma. Objective: This study aimed to review the main diagnostic criteria for temporomandibular joint ankylosis, emphasizing the most relevant clinical and imaging aspects, as well as presenting the main treatment modalities, highlighting the need to differentiate between fibrous and bony ankylosis, given that therapy varies considerably. Methods: This is a narrative literature review, conducted through searches in the PubMed database, using the descriptors 'Temporomandibular Joint Disorders', 'Ankylosis' and 'Diagnosis', operationalized by the Boolean operators AND and OR, following MeSH standards, selecting studies published in the last five years, with full text available and written in English or Portuguese, that maintained a direct focus on the subject. Publications without a direct correlation to the topic, duplicate articles, narrative reviews of low rigor, and non-indexed texts were excluded. Results: The findings demonstrate that the diagnosis of temporomandibular joint (TMJ) ankylosis should be based on the association between clinical signs, such as severe trismus, pain, and functional limitations, and imaging exams, especially computed tomography, which makes it possible to identify the extent of the ankylosed mass and its relationship with adjacent structures. From the reviewed publications, it is evident that early diagnosis and intervention are decisive factors in achieving satisfactory functional and aesthetic results. Conclusions: Early diagnosis, combined with the use of appropriate imaging methods, is crucial for better aesthetic and functional outcomes, especially in young patients, in whom complications related to ankylosis can be even more debilitating. The distinction between fibrous and bony ankylosis is essential, considering that treatment varies considerably. Although current therapies are showing promise, future studies, preferably controlled and randomized, are still needed to seek standardized treatment modalities, aiming to reduce the rate of associated complications.