First Total Temporomandibular Joint(TMJ) replacement at AIIMS

In a first of its kind in India, a 19-year-old boy who could not open his mouth for the last 8 years successfully underwent a complex surgery, called Total Temporomandibular Joint(TMJ) replacement here at AIIMS today.
Shivam, who could not speak as his jaw joint had fused to his skull base after he fell flat on his face while flying kite eight years ago, was surviving on liquids.
However, A team of doctors at the Centre for Dental Education and Research, AIIMS performed the Total Temporomandibular Joint replacement.
"The condition from which Shivan suffered is called Total Temporomandibular Joint (TMJ) Ankylosis, which is generally caused due to trauma or fall, ear infection or inflammation.

"TMJ is the point of attachment of the lower jaw to the skull and it is the most complex joint of the human body. This replacement in the patient is now allowing him to open his mouth and talk and eat," said Ajoy Roychoudhury, Professor and Head of the Department of oral and maxillofacial surgery at AIIMS.
"There are other treatment options like like gap arthroplasty, interpositional arthroplasty with autogenous bone graft such as ribs and sternoclavicular joint, but the chances of recurrence in these are high due to excessive hetrotrophic bone formation around operated site," explained Roychoudhury.
The TMJ replacement allows reproduction of the natural anatomy, avoids donor site morbidity, reduces surgery time and lessen the risk of re-ankylosis, said Ongkila Bhutia, another senior dental surgeon who was part of the surgery team.

At present, the surgery costs over 3 lakh for the both side jaw replacement as the transplants have to be ordered from India.