Total Temporomandibular Joint Prosthetic Reconstruction: The Importance of Lateral Pterygoid Muscle Reattachment to Lateral Excursive and Protrusive Mandibular Movement

Abstract

AbstractSevere temporomandibular joint (TMJ) disorders result in structural changes that can significantly and negatively impact the jaw and airway, resulting in pain, difficulty chewing, dietary restrictions, sleep apnea, and other functional changes.1 For more than 5 decades, alloplastic total TMJ replacement has been used to treat end-stage intra-articular TMJ disorders. Commonly accepted measures of postsurgical success include maximal incisal opening (MIO), pain relief, and dietary and functional improvement.1Diminished or unimproved lateral and protrusive jaw movement is a commonly accepted consequence of complete TMJ replacement.2 Lateral excursive and protrusive function should, however, be considered and reported as an important measure of success after alloplastic TMJ replacement. To achieve such success, surgeons must comprehensively plan the reconstruction and reattach the lateral pterygoid muscle's inferior head (LPM-IH) to the prosthetic TMJ to support normal functional occlusion and mandibular motion.