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CASE REPORT – CYST & TUMORS
Year : 2020  |  Volume : 10  |  Issue : 1  |  Page : 275-278

Patient-specific implant for temporomandibular joint replacement in juvenile arthritis and facial asymmetry


1 Center of Excellence in Morphological and Surgical Studies, Universidad de La Frontera, Temuco; Division of Oral and Maxillofacial Surgery, A.G.P. General Hospital, Lautaro, Chile
2 Department of Biomedical Research Enterprises, Pinhais, Paraná, Brazil
3 Center of Excellence in Morphological and Surgical Studies, Universidad de La Frontera; Division of Oral and Maxillofacial Surgery, H.H.A. General Hospital, Temuco, Chile
4 Division of Oral and Maxillofacial Surgery, A.G.P. General Hospital, Lautaro, Chile

Correspondence Address:
Prof. Sergio Olate
Center of Excellence in Morphological and Surgical Studies, Universidad de La Frontera, Claro Solar 115, Temuco
Chile
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DOI: 10.4103/ams.ams_82_19

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The aim of this report is to present a patient with juvenile arthritis, condylar resorption, and residual facial asymmetry treated with orthognathic surgery and unilateral joint replacement with a full three-dimensional computer-aided design and computer-aided manufacture (CAD-CAM) temporomandibular joint (TMJ) prosthesis, including an increase in the left ramus and mandibular angle to achieve facial symmetry. The patient, a 30-year-old male, came to our department for orthosurgical treatment. The patient had been receiving treatment for juvenile arthritis for 15 years; at facial level, he had a chin deviation of 12 mm from the facial midline, maxillary retrusion, and Angle Class III. The computed tomography revealed a reduced height of the left condyle and a significant difference in the morphology of the mandibular ramus and angle. Using CAD-CAM technology and additive manufacturing, a TMJ prosthesis was produced, through the use of the mirror image, orthognathic surgery was realized using the right side as “esthetic side” with suitable shape and angulation. The prosthesis was created, and this was taken to the surgery. The surgery was performed without problems, a mouth opening of 35 mm and absence of pain were noted after 12 months of follow-up. The surgery remained stable, and facial symmetry was restored. In conclusion, it is viable to develop a TMJ prosthesis by CAD-CAM that includes esthetic modifications to the face; prospective and clinical studies must be conducted to confirm protocols.


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