Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial · Published 2026-06-30 · DOI 10.24873/j.rpemd.2026.06.1570
Muhammad Khan, Hadia Shehzad, Asra Hayat, Qazi Hayat
Objectives: To evaluate postoperative maximal inter-incisal opening and facial nerve injury following gap arthroplasty, and to assess the influence of Sawhney classification on these outcomes. Methods: Data from 103 patients (Sawhney Class II, n=28; Class III, n=75) undergoing gap arthroplasty were reviewed. Postoperative maximal inter-incisal opening and facial nerve weakness were recorded at outpatient follow-up (mean 2.26 months, SD 1.42; range 1–8 months). All continuous variables showed non-normal distribution (Shapiro-Wilk p<0.05); the Mann–Whitney U test and Fisher’s exact test were applied. A Kruskal-Wallis test was used for age-stratified mouth opening analysis. Preoperative maximal inter-incisal opening was not available, precluding pre-post comparison. Results: Mean age was 12.26 ± 3.35 years. Falls were the leading cause (80.6%). Mean postoperative maximal inter-incisal opening was 28.42 ± 7.09 mm (range 5–42 mm); 71.8% of patients achieved ≥25 mm. No significant difference in mouth opening was observed between Class II (28.43 ± 5.17 mm) and Class III (28.45 ± 7.71 mm; p=0.991). Age-stratified analysis showed progressively higher postoperative mouth opening in older patients (5–9 years: 24.8 mm; 10–13 years: 28.9 mm; 14–17 years: 30.4 mm; Kruskal-Wallis p=0.038). Facial nerve weakness occurred in 21.4% of patients overall (Class II: 21.4%; Class III: 21.3%), with no association with Sawhney classification (p=1.000). Conclusion: Gap arthroplasty resulted in satisfactory short-term mouth opening. Sawhney classification did not influence maximal inter-incisal opening or facial nerve injury risk. Postoperative mouth opening was positively associated with patient age, consistent with expected developmental growth patterns. The absence of preoperative data and short follow-up are primary limitations. Prospective studies with long-term follow-up are recommended.
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Khan, M., Shehzad, H., Hayat, A., et al. (2026). Gap arthroplasty outcomes in temporomandibular joint ankylosis: a retrospective study. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial. https://doi.org/10.24873/j.rpemd.2026.06.1570