[Reconstruction of the temporomandibular joint and its alternatives]

Reconstruction of the temporomandibular joint is always quite problematic. --Use of a prosthesis. Many prostheses have been propounded to deal with the operational problems. As, in our opinion, these seem not to meet the usual orthopaedic surgery requirements, we developed a totally intermediate prosthesis with non-sealed cupula. The use of this prosthesis, whenever feasible, provides the solution for the problems with which we have to contend during reconstruction surgery in traumatology and degenerative or tumoral disease. Nonetheless, its use remains limited to adults. --Utilization of biological material: following numerous attempts made with the conventional osteocartilagenous grafts (metatarsal, rib), we believe that the proper orientation, walking in Chang's footsteps, is toward the use of the head of the second metatarsal bone as a microanastomotic transfer. It seems to us that this technique must be used in children, particularly those with malformation syndromes or ankylosis.