TMJ Replacement Following Pseudoarthrosis of Condylar Neck Fracture With Dislocation of the Condylar Neck Within the Infra-Temporal Fossa

Abstract

Study Design: Case Report Objective: To present a patient with long-standing TMJ dislocation and pseudoarthrosis in the temporal bone treated with orthognathic surgery and unilateral joint replacement. Method: The patient, a 52-year-old female, came to our department to treat facial asymmetry and oral rehabilitation. The patient reported early facial trauma at 7 years old showing partial edentoulism, dental occlusion class III and a 19 mm mandibular midline deviation. Cone beam computed tomography showed the left TMJ in long-standing dislocation into the fossa temporalis, creating a new articular fossa in the temporal bone and adaptation of the hard and soft tissue. Results: Orthognathic surgery and TMJ replacement using a patient-specific implant and dental rehabilitation were planned; surgery was performed with no complications, and the 1-year follow-up showed that this treatment was a good option for long-standing TMJ dislocation. Conclusion: The long-term TMJ dislocation can be successfully treated by TMJ replacement using a patient-specific implant to obtain facial balance and oral function and avoid relapse.