Bilateral Temporomandibular Joint Replacement Using Computer-Assisted Surgical Simulation and Three-Dimensional...

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Dental Implantology

Background:

• Dental occlusion is crucial for temporomandibular joint (TMJ) replacement.
• Patients with abnormal occlusion require special considerations for TMJ prostheses.
• Custom-made prostheses offer optimized solutions but ready-made options are limited.

Observation:

• A patient presented with a retrognathic "bird face" profile due to severe bilateral condylar resorption and TMJ ankylosis.
• The patient lacked sufficient natural teeth for proper occlusion.
• The only government-authorized stock prosthesis in South Korea is from Biomet Microfixation System.

Findings:

• Bilateral TMJ replacement was performed using a ready-made stock prosthesis.
• Virtual surgical planning and stereolithographic model simulation were utilized.
• The procedure reestablished mandibular position, created new occlusion, and improved facial profile.

Implications:

• Ready-made TMJ prostheses, guided by virtual planning and simulation, can effectively treat complex cases of condylar resorption and ankylosis.
• This approach offers a viable solution for patients with limited natural dentition and significant facial deformities.
• The study highlights the potential of stock prostheses in conjunction with advanced planning for TMJ reconstruction.