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[Total temporomandibular joint replacement with alloplastic prosthesis].

Marco Antonio García-Huerta¹, Jovita Romero-Flores, Eddy Mena-Gómez

¹Servicio de Cirugía Maxilofacial, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.

Revista Medica Del Instituto Mexicano Del Seguro Social

|December 14, 2012

Summary

Total temporomandibular joint (TMJ) replacement effectively treated TMJ ankylosis in two patients. Surgeries resulted in significant improvements in mandibular movement and stable outcomes with no long-term complications.

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Area of Science:

Oral and Maxillofacial Surgery
Orthopedic Surgery
Biomedical Engineering

Background:

Temporomandibular joint (TMJ) ankylosis, a condition restricting jaw movement, can result from trauma or developmental issues.
Traditional treatments for TMJ ankylosis may have limitations, necessitating advanced surgical solutions.
The W. Lorenz system offers a prosthetic option for total TMJ replacement.

Observation:

Three total TMJ replacement surgeries were performed on two patients diagnosed with TMJ ankylosis.
One patient had osseous ankylosis with complete loss of mandibular movement since early childhood.
The second patient presented with fibrous ankylosis secondary to an untreated subcondylar fracture, exhibiting limited jaw opening.

Findings:

The first patient underwent bilateral TMJ replacement, while the second had a unilateral replacement.

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Postoperative follow-up of eight months revealed significant interincisive opening distances of 29 mm and 34 mm, respectively.

Both patients experienced no mandibular deviation during opening, no postoperative pain, and only transient facial nerve affection.

Implications:

Total TMJ replacement using the W. Lorenz system demonstrates efficacy in restoring mandibular function in patients with severe TMJ ankylosis.
The procedure offers stable, long-term functional results with a favorable safety profile.
This approach represents a viable and effective treatment option for complex TMJ ankylosis cases previously managed with limited success.