Role of Temporomandibular Total Joint Replacement in Correction of Facial Deformities.

Abstract

Individuals suffering from facial deformities experience esthetic, functional and social setback in their lives every day. These patients benefit greatly with single-stage temporomandibular joint replacement along with orthognathic surgical procedures to correct functional as well as esthetic components. Five individuals with facial deformities due to hemifacial macrosomia, fibrous dysplasia, idiopathic condylar resorption, ankylosis, etc., were treated with total joint replacement along with orthognathic surgical procedures for functional and esthetic correction. The customized temporomandibular joint was digitally custom designed, and the orthognathic procedures were virtually planned on NemoFAB software before performing the surgical procedure. Intraoperatively, the overall time was reduced considerably with minimal unpredictable complications. One-week postoperative computed tomographs were obtained and superimposed on preoperative virtual surgical planning which showed minimal discrepancy. Follow-up period of 18-30months was maintained for all the patients with stable results, minimal relapse and satisfactory functional abilities. Total joint replacement along with orthognathic procedure provides single-stage functional and esthetic corrections for the patients, considerably improving their quality of life. Precise preoperative surgical planning proves to be an indispensable step for achieving desired results with minimal margin of error and avoid any unseen complications during the surgical procedure.