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Total Temporomandibular Joint Replacement and Simultaneous Orthognathic Surgery Using Computer-Assisted Surgery.

Natalia Lucia Gomez1, Luis Alejandro Boccalatte1, Águeda Lopez Ruiz2

  • 1Head and Neck Surgery Section, General Surgery Department, Hospital Italiano de Buenos Aires, Peron 4190, 1181 Buenos Aires, Argentina.

Journal of Maxillofacial and Oral Surgery
|August 19, 2021
PubMed
Summary
This summary is machine-generated.

Computer-assisted surgery (CAS) enables single-stage orthognathic surgery combined with temporomandibular joint (TMJ) replacement. This approach offers predictable outcomes for complex facial reconstruction procedures.

Keywords:
Computer-assisted surgeryIntraoperative navigationOrthognathic surgeryTemporomandibular joint

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Biomedical Engineering
  • Computer-Aided Surgery

Background:

  • Temporomandibular joint (TMJ) disorders often accompany facial skeleton abnormalities, necessitating surgical correction.
  • While traditionally requiring staged procedures, advancements like computer-assisted surgery (CAS) facilitate single-stage interventions.
  • CAS enables complex procedures, including TMJ replacement alongside orthognathic surgery, for improved anatomical and functional outcomes.

Purpose of the Study:

  • To present a protocol for orthognathic surgery integrated with unilateral and bilateral TMJ replacement using patient-fitted prostheses.
  • To demonstrate the application of CAS in guiding these complex, combined surgical procedures.

Main Methods:

  • The study illustrates the protocol through two patient cases.
  • Utilized CAS for designing patient-fitted prostheses and intraoperative navigation.

Main Results:

  • Achieved high accuracy in TMJ replacement, with minimal deviations between planned and actual surgical outcomes (e.g., < 2.6 mm).
  • The second case showed slightly larger, yet clinically insignificant, differences due to anatomical variations.

Conclusions:

  • Combined midface and mandible surgery with total TMJ replacement is a feasible and advantageous treatment option.
  • CAS significantly enhances the planning, prosthesis design, and execution of these intricate surgical procedures, leading to beneficial patient outcomes.