Updates on temporomandibular joint reconstruction following ablative surgery.

Abstract

Considerations regarding reconstruction of the temporomandibular junction (TMJ) following ablation have been underreported in head and neck surgery literature. Here, we discuss the complexity of reconstructing this unique joint and highlight the benefits and drawbacks of free tissue transfer. Additionally, we address the growing role of customized alloplastic implants and virtual surgical planning technologies in TMJ reconstruction. Technological advances in computerized manufacturing, 3D printing, and virtual reality have led to a recent burgeoning in patient-specific customization that may become the method of choice in these complex reconstruction cases. Since trauma and malignancy rarely compromise the entire TMJ, guidelines currently do not exist regarding how to best reconstruct the region in these unique cases. The methods that work in ankylosis and other intrinsic joint diseases are likely less appropriate in this patient population. Recent literature has reported improved patient outcomes and reduced operative times with virtual surgical planning techniques that may optimize autogenous graft approaches.