Custom CAD/CAM total temporomandibular joint reconstruction system: preliminary multicenter report

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Engineering
• Medical Device Technology

Background:

• Temporomandibular joint (TMJ) disorders often require complex reconstructive solutions.
• Custom computer-assisted design/computer-assisted manufacturing (CAD/CAM) systems offer potential for precise TMJ reconstruction.
• Evaluating the efficacy of custom CAD/CAM TMJ reconstruction is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the clinical outcomes of a custom CAD/CAM total temporomandibular joint (TMJ) reconstruction system.
• To evaluate the system's effectiveness in patients with a history of multiple prior surgeries or significant anatomical damage.

Main Methods:

• A cohort of 215 patients (363 joints) underwent custom CAD/CAM total TMJ reconstruction.
• Preoperative and postoperative data were collected for up to 48 months, including subjective pain, function, diet (visual analogue scale), and objective mandibular range of motion.
• Statistical analysis and life table analysis were used to evaluate outcomes and prosthesis durability.

Main Results:

• Statistically significant improvements were observed in pain reduction, jaw function, and diet quality (P < .0001) at 1 and 2 years postoperatively.
• Mandibular vertical range of motion also showed improvement.
• The number of previous surgeries was a significant predictor of postoperative outcomes.

Conclusions:

• The custom CAD/CAM total TMJ reconstruction system demonstrates positive preliminary results.
• The system appears effective for treating patients with multiply operated or anatomically mutilated TMJs.
• Further long-term studies are warranted to confirm durability and refine treatment protocols.