PMC4007372_01
Computerized 
tomography showing ankylosis of the left tempormandibular joint.
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fig1
After the second surgery, the range of mandibular  movements decreased rapidly, and the patient was referred to our clinic.  The maximum mouth opening was 5 mm, with absence of end-feel distance,  and computerized tomography showed ankylosis of the left TMJ (Figure 1).  A Research Diagnostic Criteria for TMD (RDC/TMD) Axis I diagnosis  of disc displacement with reduction (group II a) and osteoarthritis  (group III b) was made for the right joint.
Intraoperative 
photograph showing aggressive excision of the fibrous and/or 
bony mass.
jomr-05-e6-g002.jpg
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fig2
Once access to the TMJ was gained  through the preauricular incision, the release of the ankylosis was  performed (Figure 2).
Ortopantomography 
performed immediately after surgery.
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fig3
Only after verifying the correct functioning  and freedom of movement of the implant, the patient was then sutured and  a control ortopantomography was taken (Figure 3).
Computerized 
tomography showing heterotopic bone formation around the TMJ 
prosthesis.
jomr-05-e6-g004.jpg
PMC4007372_01_jomr-05-e6-g004.jpg
fig4
A computerized tomography  showed evidence of marked heterotopic bone formation in the medial  aspects of the joint (Figures 4 and 5).
Computerized 
tomography showing the new bone in the medial aspects of the 
joint.
jomr-05-e6-g005.jpg
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fig5
A computerized tomography  showed evidence of marked heterotopic bone formation in the medial  aspects of the joint (Figures 4 and 5).