Virtual Surgical Planning for Temporomandibular Joint Reconstruction with Stock TMJ Prostheses: Pilot Study

Area of Science:

• Oral and Maxillofacial Surgery
• Biomedical Engineering
• Orthopedic Surgery

Background:

• The temporomandibular joint (TMJ) is anatomically complex, often requiring prosthetic replacement when conservative treatments fail.
• Stock temporomandibular joint prostheses (STMJP) present a more accessible and cost-effective alternative to custom prostheses.

Purpose of the Study:

• To evaluate the efficacy of stock TMJ prostheses (STMJP) combined with virtual surgical planning (VSP) and surgical guides for TMJ reconstruction.
• To assess improvements in mandibular function and pain reduction in patients undergoing TMJ reconstruction with STMJP.

Main Methods:

• A case series involving four patients with temporomandibular dysfunction previously treated with multiple surgeries.
• Reconstruction was performed using stock TMJ prostheses (STMJP) guided by virtual surgical planning (VSP) and STL models with surgical guides.
• Patients were followed for a median of 15 months, with pre- and post-operative measurements of maximal incisor overlap (MIO) and pain scores.

Main Results:

• Patients experienced a significant improvement in maximal incisor overlap (MIO), increasing from a mean of 24.6 mm preoperatively to 36.4 mm at longest follow-up.
• Median TMJ pain scores decreased substantially from 8 preoperatively to 3 postoperatively.
• All patients demonstrated improved mandibular function compared to their baseline condition.

Conclusions:

• Stock TMJ prostheses (STMJP), when utilized with virtual surgical planning (VSP) and surgical guides, represent a viable option for TMJ reconstruction.
• Further prospective, randomized trials with long-term follow-up are necessary to definitively establish the performance and safety of this approach.