A Novel Alloplastic Patient-Specific Temporalis Tendon Enthesis for Mandibular Resection With Coronoidectomy: A Case...

To introduce a novel modification for the reconstruction plate used for patients with segmental lateral mandibular defect with coronoidectomy by the introduction of an alloplastic enthesis for the temporalis tendon.

The study is a prospective case series conducted on five consecutive patients who require mandibular resection with a proximal osteotomy that requires coronoidectomy and temporalis tendon detachment and consequent reattachment to a patient-specific mandibular reconstruction plate with an alloplastic temporal enthesis. Complications and aesthetic morbidities were recorded along with mandibular kinematics, which included the masticatory muscles activity symmetry index, maximum voluntary bite force and maximum incisal opening.

Neither short-term nor long-term chin midline deflection on opening was reported. The measured inter-incisal opening reverted to normal values at T2. Ipsilateral bite force showed statistically insignificant changes across the follow-up period (p = 0.084), while significant changes were reported in the contralateral side (*p < 0.001). The alteration in the reported masseter symmetry index was more prominent than in the temporalis fibres. The temporalis-SI showed a low asymmetry outcome in all assessment sessions.

The utilisation of an alloplastic temporalis enthesis in the design of a custom-reconstruction plate showed an outstanding clinical performance, with negligible aesthetic morbidity in the short and long term. The electrical temporalis muscle symmetry assessment stated a low asymmetry outcome, which indicates muscular fibre length preservation and prompt recovery of its synergistic action.

ClinicalTrials.gov identifier: NCT06770868.