Custom-made Total Joint Replacement for the Management of Recurrent Bilateral Temporomandibular Joint Ankylosis - A...

Recurrent bilateral temporomandibular joint (TMJ) ankylosis poses a significant challenge due to limited treatment options and extensive functional impairment. Alloplastic total joint replacement (TJR) represents a potential solution, particularly custom-made devices that allow for precise anatomical reconstruction. However, data on the efficacy of custom-made TJR in this specific population remains limited. This study aimed to evaluate the functional outcomes of custom-made alloplastic TJR in managing recurrent bilateral TMJ ankylosis. Specific outcomes assessed include maximal incisal opening (MIO), postsurgical malocclusion, heterotopic bone formation and dietary restriction patient satisfaction.

This study was a retrospective study on six patients who underwent custom-made alloplastic TJR for recurrent bilateral TMJ ankylosis at a single institution. Preoperative and postoperative MIO and dietary restrictions were evaluated. Radiographic assessments, complications, patient satisfaction and quality of life after surgery were documented.

Custom-made TJR resulted in a significant increase in mean MIO from 5.5 mm (standard deviation [SD]: 5.54 mm) preoperatively to 35.17 mm (SD: 2.99 mm) at 1-year follow-up. All patients demonstrated improvement in dietary restrictions. The radiographic assessment showed stable prostheses. No major complications were observed, and all patients reported satisfaction with the surgical outcome.

This study suggests that custom-made alloplastic TJR is a viable treatment option for patients with recurrent bilateral TMJ ankylosis, leading to substantial improvements in mouth opening, pain reduction and overall function. Larger, prospective, multi-centre studies are needed to confirm these findings and further evaluate the long-term outcomes.