Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases
A 21-year-old male patient--who had undergone closed reduction for the fracture of bilateral mandibular condyle caused by a traffic accident five years ago--visited the hospital with limitation of mouth opening and pain on the left TMJ. He also had no specific medical history and showed limitation of mouth opening (approximately 16 mm) accompanying TMJ pain and crepitus on the left side along with troubled lateral excursion. The computed tomography image revealed signs of fibrous ankylosis and heterotopic bone formation on the postero-lateral surface of the left condyle head and temporal bone.(, ) The plan of combined gap arthroplasty and total TMJ replacement was finally established.\nGap arthroplasty was performed, including condylectomy and excision of the 40×30×30 mm lesion of fibrous and bony ankylosis in the left TMJ.() After normal range of jaw movement (approximately 30 mm) was secured, retromandibular incision was done. Bone trimming of articular eminence was consequently conducted, followed by the installation of prosthetic components.() Postoperatively, the patient also began light mouth opening exercise followed by subsequent active exercise and achieved approximately 40 mm mouth opening in 2 months. He showed no loosening or missing of screws in the prosthetic component (, ) and substantial alleviation of pain on the ipsilateral joint and maintained up to 40 mm mouth opening.(, )