What is the best treatment for a child with boney TMJ ankylosis?

The treatment of choice for a child with bony temporomandibular joint (TMJ) ankylosis is best represented by the use of a costochondral graft. This procedure involves harvesting a portion of costal cartilage from the rib and using it to reconstruct the affected TMJ.

In children, where bone growth and development are ongoing, the costochondral graft is particularly advantageous because it has the ability to grow with the child. This is crucial in preventing the recurrence of ankylosis and ensuring proper function of the jaw as the child matures. The graft not only replaces the deficient anatomical structures of the TMJ but also serves as a dynamic element that can adapt to the child's growth over time, thereby addressing both functional and aesthetic concerns.

Other procedures, such as discectomy, arthroplasty, and joint reconstruction, may have roles in treating TMJ disorders, but they do not offer the same long-term growth potential necessary in a pediatric population. Discectomy typically removes the articular disc, which can lead to further complications and does not solve the underlying bony fusion. Arthroplasty may not provide enough stability or growth potential for a child with ankylosis, while joint reconstruction is often more complex and