J Korean Assoc Oral Maxillofac Surg.  2013 Dec;39(6):297-303. 10.5125/jkaoms.2013.39.6.297.

Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases

• Lee SH
• Ryu DJ
• Kim HS
• Kim HG
• Huh JK

• KMID: 1960981
• DOI: http://doi.org/10.5125/jkaoms.2013.39.6.297

Abstract

Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.

Keyword

Temporomandibular joint disorders; Replacement arthroplasty; Maxillofacial prosthesis; Temporomandibular ankylosis

MeSH Terms

Arthroplasty, Replacement
Female
Follow-Up Studies*
Humans
Male
Maxillofacial Prosthesis
Middle Aged
Osteochondroma
Prostheses and Implants*
Skull Base
Temporomandibular Joint Disorders
Temporomandibular Joint*
Transplants
United States Food and Drug Administration
Young Adult

Figure

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  Fig. 1 Pre-condylectomy radiography and computed tomography (Case 1). Radiopaque mass extendingantero-superiorly from left condyle. A. Panoramic view. Well-demarcated lesion extended to the cranial base, on left condyle (arrowheads). B. Cross-sectional view. C. Coronal view. D. Sagittal view.

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  Fig. 2 Preoperative radiography (Case 1) show previous condylectomy area on left temporomandibular joint (TMJ) (arrow). A. Panoramic view. B. Postero-anterior cephalogram. C. TMJ tomogram. D. Lateral cephalogram.

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  Fig. 3 Postoperative 1-year radiography (Case 1). A. Panoramic view. B. Postero-anterior cephalogram. C. Temporomandibular joint tomogram. D. Lateral cephalogram.

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  Fig. 4 Preoperative radiography (Case 2). The lesion of fibrous and bony ankylosis was suspected on left temporomandibular joint (TMJ) (arrowheads). A. Panoramic view. B. Postero-anterior cephalogram. C. Llimitation of translation of left condyle on TMJ tomogram. D. Lateral cephalogram.

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  Fig. 5 Preoperative computed tomography (Case 2). A. Cross sectional view. B. Coronal view. C. Sagittal view.

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  Fig. 6 Intraoperative photographs (Case 2). A. Removal of lesion of fibrous and bony ankylosis on left temporomandibular joint. B. Adaptation of fossa component. C. Adaptation of condyle component. D. Confirmation of range of motionwith the maximal mouth opening above 30 mm.

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  Fig. 7 Computed tomogram of 5 days after surgery. Axial (A), coronal (B), sagittal (C) view and 3 dimensional reconstruction images (D, E) comparing preoperative and postoperative 5 days.

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  Fig. 8 Postoperative 1-year radiography (Case 2). A. Panoramic view. B. Postero-anterior cephalogram. C. Temporomandibular joint tomogram. D. Lateral cephalogram.

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  Fig. 9 Preoperative and postoperative (6 months) maximal mouth opening (MMO) (Case 2). A. Preoperative MMO was 16 mm. B. At postoperative 6 months MMO have increased to 38 mm.

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