Surgical correction of facial asymmetry without bone grafting for unilateral temporomandibular joint ankylosis

Abstract This case report evaluated the clinical value, therapeutic effectiveness, and stability of a bilateral sagittal split osteotomy of the rami (BSSRO) and genioplasty, without temporomandibular joint (TMJ) bone grafting, for the treatment of mandibular asymmetry and deviation in patients with unilateral TMJ ankylosis. A 2-stage procedure was planned, with an initial release of the TMJ, using a gap arthroplasty, followed by orthognatic treatment for the maxillofacial deformities. This orthognathic surgical approach is suitable for patients who only need a slight mandibular advancement, without a vertical height increase. In this case, acceptable occlusion and facial esthetics were obtained, with results being stable over a 4-year postoperative follow-up.