Single-stage temporomandibular joint arthroplasty in a patient with complete bony ankylosis and previous extradural haematoma

Total Alloplastic Temporomandibular Joint Replacement

Purpose

End-stage temporomandibular joint (TMJ) disease are not uncommon and affects quality of life. Multiple surgical procedures have been mentioned in literature for management of TMJ disease which ranges from conservative management to aggressive resection of involved joint and replacement with alloplastic total joint prosthesis. The purpose of the present paper was to provide an overview of the role of alloplastic total joint prosthesis in TMJ replacement.

Methods and results

Alloplastic total joint prosthesis is nowadays considered as a standard of care in the adult patients who require TMJ replacement. The requirement of alloplastic total prosthesis has increased in present era with the improvement in design and material of implants, surgical skills and reported victorious outcome along with improved quality of life after its use. It provides restoration of form and functions, improvement in quality of life, reduction in pain and maintenance of ramal height. Additionally, in TMJ ankylosis it reduces chances of re-ankylosis and allows facial asymmetry correction. Currently, enough evidence is however not available for replacement in skeletally immature patient.

Conclusion

The authors conclude that the total joint replacement is a standard procedure for end-stage TMJ disease. Every maxillofacial surgeon should be well-acquainted with TMJ replacement.

Alloplastic total joint replacement in management of temporomandibular joint ankylosis

Both autogenous and alloplastic material have been used in management of temporomandibular joint (TMJ) ankylosis. Second surgical site, donor site morbidity, possibility of over/undergrowth, graft fracture or resorption and increased surgical time are the disadvantages of autogenous graft. Alloplastic total joint replacement (TJR) has become a promising technique in management of adult temporomandibular joint ankylosis (TMJA). This paper intends to present the role of alloplastic TJR in management of TMJA. There is significant current evidence of the role of alloplastic TJR in the management of TMJA. Results in TMJA are excellent with sustained improvement in pain free mouth opening, correction of facial asymmetry, reduction in recurrence and improved quality of life. TMJ TJR is becoming the gold standard of care in the management of TMJA, although costs can sometime preclude access to this mode of therapy.