S4B-10 SESSION 4B: ORTHOGNATHIC / TREACHER-COLLINS PROSTHETIC TMJ RECONSTRUCTION WITH AND WITHOUT ORTHOGNATHIC SURGERY IN A COHORT OF ADOLESCENT FEMALES

Abstract

Introduction: Temporomandibular joint (TMJ) reconstruction may be necessary for a variety of reasons, including ankylosis, arthritis, tumors, or resorption. Choice of autogenous or prosthetic reconstructive method is largely operator-dependent. Often, significant jaw deformities must be corrected concurrently. The purpose of this presentation is to review results in a series of adolescent females who underwent prosthetic TMJ replacement, many simultaneous with orthognathic surgery, for a variety of pathologies. Methods: In a five year period, all patients who underwent alloplastic total joint replacement were reviewed. Diagnosis, surgical strategy, complications, and outcomes were analyzed. Results: Nine patients, all female, ages 14–18, underwent a total of 16 prosthetic joint replacements. Follow-up ranged from 6 months to 3 years. Diagnoses included juvenile arthritis, craniofacial microsomia, Robin Sequence, and idiopathic condylar resorption. Three of the patients exhibited overt TMJ ankylosis. Seven of the nine patients demonstrated significant dentofacial deformities, all of whom underwent simultaneous or staged orthognathic surgery utilizing 3D treatment planning. All achieved good range of motion with resolution of pain. A stable occlusion was achieved in all cases except one. There were two early postoperative infections, which responded to localized drainage and antibiotics. Three patients developed temporary facial weakness. There have been no implant failures with retention of all implants so far. Conclusion: Early results show that prosthetic joint replacement is a desirable alternative to restore TMJ function in the adolescent population and may be combined with orthognathic surgery to correct concurrent jaw deformities.