Mohammed Shorafa, Omar Sheikh, Peter Ayliffe

1. Initial report of use of Indomethacin in improving mouth opening and preventing re-ankylosis in TMJ ankylosis Mohammed Shorafa, Omar Sheikh, Peter Ayliffe

2. Introduction Indomethacin is a non-selective inhibitor of cyclooxygenase one and two, enzymes that participate in prostaglandin synthesis from arachidonic acid. Indomethacin is used most commonly for the treatment of inflammation and pain resulting from rheumatic disease. Orthopaedic surgeons have been using Indomethacin for many years to prevent the formation of heterotopic bone after hip replacement surgery. Studies have demonstrated that indomethacin is a potent inhibitor of local remodelling and repair of bone after trauma. To our knowledge there are no reports in the literature of the use of Indomethacin post operatively to prevent TMJ ankylosis or its use to improve TMJ mobility pre or post operatively.

3. Method Indomethacin was given to patient in divided doses dependant on weight pre-operatively and following TMJ ankylosis surgery. Indomethacin was used in our department over the last four years. A smaller group who were unable to tolerate the drug were selected as our control. Results Our findings show that use of Indomethacin in TMJ ankylosis showed either greater mouth opening or that similar to the smaller control group who were not administered the drug due to gastro-intestinal complications or parents’ refusal.

4. Indomethacin group Control group

5. Conclusion TMJ ankylosis is difficult to treat. Many patients show early improvement but relapse at a later date. Initial results have been favourable, providing a solution for many of our patients however further research is warranted in the form of a randomized, double-blind clinical trial.