Temporomandibular Joint Gap Arthroplasty in Cats

Area of Science:

• Veterinary Surgery
• Comparative Orthopedics
• Maxillofacial Surgery

Background:

• Temporomandibular joint (TMJ) ankylosis involves fibrous or bony fusion within the joint.
• It can be intraarticular, extraarticular, or both, significantly impacting jaw function.
• Severe TMJ ankylosis presents a surgical challenge in feline patients.

Purpose of the Study:

• To detail the surgical planning, technique, and outcomes of gap arthroplasty for extensive TMJ ankylosis in cats.
• To evaluate the efficacy of cone-beam computed tomography (CBCT) and 3D printing in surgical planning.
• To assess the use of piegosurgery in treating feline TMJ ankylosis.

Main Methods:

• Seven client-owned cats with extensive TMJ ankylosis underwent clinical examination and surgical planning.
• Cone-beam computed tomography (CBCT) and 3D printed models were used for precise surgical planning.
• Gap arthroplasty involved zygomectomy, coronoidectomy, condylectomy, and fossectomy, performed with a piezosurgical unit.

Main Results:

• All seven cats achieved clinically acceptable mouth opening post-gap arthroplasty without immediate surgical complications.
• Mandibular instability was noted in all cases following the procedure.
• Medium-term follow-up showed acceptable quality of life, with two cases experiencing recurrence of ankylosis.

Conclusions:

• Gap arthroplasty serves as a viable salvage procedure for severe intra- and extraarticular TMJ ankylosis in cats.
• CBCT and 3D printing are crucial for accurate surgical planning in complex TMJ cases.
• Piezosurgery enables safe and precise bone resection, and despite instability, functional feeding was possible.