Management of dentofacial deformities and facial asymmetry with orthognathic surgery concomitant alloplastic temporomandibular joint replacement whit stock prosthesis

Abstract

Temporomandibular joint (TMJ) disorders or pathology and dentofacial deformities (DFD) commonly coexist. The TMJ pathology may be the causative factor of the jaw deformity or develop as a result of the jaw deformity. Total alloplastic replacement is indicated in TMJ ankylosis, congenital deformation or absence of the TMJ, other end-stage TMJ pathologies, etc. Studies have shown that both custom and stock alloplastic TMJ replacements resulted in statistically significant improvement in pain level, jaw function, and incisal opening. The TMJ stock prosthesis has the advantage of having a more flexible adjustment and lower cost compared to custom made prosthesis, also has immediate placement availability. Objective: The aim of this study is to describe stock alloplastic TMJ total replacement with orthognathic surgery in patients with DFD and concomitant facial asymmetry. Methods: Two patients presenting with congenital and acquired disease DFD and facial asymmetry underwent orthognathic surgery with TMJ alloplastic replacement with stock prosthesis. All patients were planned by traditional model surgery. Conclusions: The TMJ is the basis of the mandibular position, the function, occlusion and facial balance. Several authors have described the performance of orthognathic surgery in conjunction with TMJ alloplastic replacement with custom-made prosthesis, however, there is little literature on performing orthognathic surgery concomitant with stock prosthetic.