Computer-assisted Condylar Reconstruction in Bilateral Ankylosis of the Temporomandibular Joint Using Autogenous Coronoid Process

Br J Oral Maxillofac Surg. 2011 Dec;49(8):612-7. doi: 10.1016/j.bjoms.2010.10.015. Epub 2010 Nov 16.

Abstract

During the past 10 years, more than 20 patients a year have been treated at our centre for bilateral ankylosis of the temporomandibular joint (TMJ). Here we describe the use of computer-assisted three-dimensional surgical planning and its clinical effects in condylar reconstruction for such patients using autogenous coronoid process. Sixteen patients with bilateral bony ankylosis of the TMJ from March 2006 to March 2009 were randomly divided into 2 groups and treated by bilateral osteoarthrectomy and condylar reconstruction by free grafting of autogenous coronoid process with and without three-dimensional simulation using Surgicase CMF™ (Materialise, Belgium) software. Clinical examination, radiographs, photographs, and details of the operation and its outcome were used postoperatively to evaluate the clinical effects of the technique. Satisfactory mouth opening was achieved in all cases. There were fewer postoperative malocclusions among patients who had three-dimensional simulation. The combination of computer-assisted three-dimensional surgical planning and simulation and free grafting of autogenous coronoid process is a sound and predictable method for the reconstruction of condyles in patients with bilateral ankylosis of the TMJ as it makes the operation easier and more accurate.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ankylosis / surgery*
  • Arthroplasty / methods
  • Bone Transplantation / methods*
  • Computer Simulation
  • Female
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Mandible / surgery
  • Mandibular Condyle / diagnostic imaging
  • Mandibular Condyle / surgery*
  • Osteotomy / methods
  • Patient Care Planning
  • Range of Motion, Articular
  • Surgery, Computer-Assisted*
  • Temporomandibular Joint Disorders / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult