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Computer-assisted surgery with custom prostheses and human amniotic membrane in a patient with bilateral class IV TMJ reankylosis: a case report

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Abstract

A gold-standard technique has yet to be found for the treatment of temporomandibular joint ankylosis (TMJa), particularly in patients with recurring ankylosis. A 58-year-old male patient, with a history of multiple TMJ surgeries and severe limitation of mouth opening (maximum interincisal distance [MID] was 10 mm). Computerised tomography (CT) imaging highlighted a bilateral type IV ankylosis. The surgical guides were manufactured using a 3D printing method after obtaining a proper design of the osteotomy lines. The positioning of the fossa and condyle components of the custom TMJ prosthesis was digitally performed. Osteotomies were carried out using surgical guides and TMJ prostheses were placed as per the virtual planning. A human amniotic mambrana is inserted between the two prosthetic components to avoid ranchylosis. The post-operative CT showed the correct positioning of the condylar prosthesis. MID after 10 days was 37 mm. Total joint reconstruction surgery using 3D virtual surgical planning may be an effective surgical option for achieving a precise surgical outcome and making use of a single-stage approach in cases of TMJa and the use of the amniotic membrane, thanks to its healing properties and reduction of pain perception, seems to improve the quality of the immediate post-operative period.

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The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Correspondence to Matteo Val.

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The authors declare that there is no conflict of interest regarding the publication of this article. This study followed the Declaration of Helsinki on medical protocol and ethics.

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All authors agreed with the content and all gave explicit consent to submit and that they obtained consent from the responsible authorities at the institute/organization where the work, before the work is submitted.

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The procedures employed followed the ethical standards of the 1975 Declaration of Helsinki revised in 2000. The participants underwent maxillofacial surgery treatment after signing a free and informed consent form, including the authorization for the release of images for scientific publication.

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Val, M., Ragazzo, M., Bendini, M. et al. Computer-assisted surgery with custom prostheses and human amniotic membrane in a patient with bilateral class IV TMJ reankylosis: a case report. Cell Tissue Bank 23, 395–400 (2022). https://doi.org/10.1007/s10561-021-09940-w

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  • DOI: https://doi.org/10.1007/s10561-021-09940-w

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