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Concurrent bilateral total temporomandibular joint replacement surgery and conventional maxillary osteotomy utilizing
Alexander James Hills1, Nabeela Ahmed, Nigel Shaun Matthews
1From the King's College Hospital, London, United Kingdom.
The Journal of Craniofacial Surgery
|March 25, 2014
Summary
This case study details successful bilateral total temporomandibular joint (TMJ) replacement and maxillary advancement surgery. Virtual surgical planning enabled simultaneous procedures, achieving excellent functional and aesthetic outcomes for TMJ dysfunction.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Biomedical Engineering
Background:
- A 31-year-old female presented with severe temporomandibular joint (TMJ) dysfunction and malocclusion 10 years after initial surgery.
- Previous vertical subsigmoid osteotomy resulted in condylar displacement and persistent malocclusion, leading to progressive right TMJ dysfunction and pain.
Observation:
- The patient exhibited a class III malocclusion, 5-mm anterior open bite, and right jaw deviation.
- Maximal interincisal opening was 32 mm, indicating significant functional limitation.
Findings:
- Bilateral total TMJ replacement and coronoidectomy were performed, combined with a Le Fort I osteotomy and 4-mm maxillary advancement.
- Virtual surgical planning facilitated the complex, simultaneous procedures.
Implications:
- This case represents one of the first reports of bilateral total TMJ replacement with concurrent maxillary osteotomy.
- The study highlights the potential of virtual surgical planning and the viability of performing simultaneous reconstructive procedures for complex TMJ disorders.
