[Total temporomandibular joint replacement with alloplastic prosthesis].

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.
• 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.