A structured workflow for adapting stock temporomandibular joint prostheses to custom-fit implants: bridging the gap...

Custom-made temporomandibular joint implants provide an excellent anatomical fit for total joint replacement in complex cases, but are associated with high costs and lengthy production times. In contrast, stock temporomandibular joint prostheses offer lower costs and faster availability, but lack the precision fit required for patients with altered anatomy from trauma, congenital deformities, or prior surgeries. This Technical Note presents a structured workflow that enables precise adaptation of stock temporomandibular joint implants by reshaping the patient's anatomy using virtual surgical planning, computer-aided design, and custom-made surgical guides, without altering the implant itself. Preoperative imaging was used to virtually plan the implant position and required bone modification. Based on this plan, patient-specific modification guides were produced and used intraoperatively to optimize the skeletal anatomy for improved stock implant fit. This workflow is applicable in cases where anatomical reshaping can be performed without compromising bone integrity or surgical safety, supporting broader access to personalized temporomandibular joint surgery.