Comparison of Three Osteotomy Techniques in Temporomandibular Joint Ankylosis Surgery

Temporomandibular joint (TMJ) ankylosis is a condition in which the jaw joint becomes partially or completely fused, resulting in restricted mouth opening and difficulties with chewing, speaking, and daily activities. Surgical treatment aims to remove the ankylotic bone and restore normal jaw movement. Different bone-cutting devices can be used during surgery, but their effects on surgical efficiency, postoperative recovery, and quality of life may vary. This prospective, non-randomized comparative clinical study aimed to compare three osteotomy techniques used in TMJ ankylosis surgery: piezoelectric surgery, an ultrasonic bone scalpel, and a conventional reciprocating saw. A total of 32 patients undergoing TMJ ankylosis surgery were included. Eleven patients underwent surgery using a piezoelectric device, eleven using an ultrasonic bone scalpel, and ten using a conventional reciprocating saw. All surgical procedures were performed by the same surgeon under general anesthesia using a standardized surgical protocol. The primary outcome was osteotomy time, measured during surgery. Secondary outcomes included total operative time, intraoperative blood loss, maximum mouth opening, postoperative pain, facial nerve function, and patient-reported quality of life. Facial nerve function was evaluated using the House-Brackmann grading system and the Sunnybrook Facial Grading System. Quality of life was assessed using the SF-12, WHOQOL-BREF, OHIP-14, and UW-QOL questionnaires. Patients were followed for six months after surgery to evaluate functional recovery and changes in quality of life. The study aimed to determine whether the choice of osteotomy device was associated with differences in surgical efficiency, early postoperative recovery, and patient-reported outcomes.