Technical report and rare case description—patient-specific spacer made of bone cement for the revision of a PSI-TMJ fossa after screw fracture

Abstract

Total alloplastic temporomandibular joint replacement (TMJ-TJR) has once again become the focus of therapy for end-stage destroyed joints. Although material quality has increased significantly in terms of service life and wear, problems occur even with patient-specific (PSI) prostheses. Here, mainly the ramus components are affected and an occurrence of screw loosening or fractures in the area of the fossa of stock joints is rare and has not yet been described for patient-specific (PSI) components. Although very rare, such events pose a great challenge to both practitioners and affected patients, especially in the case of PSI components, not least due to the long time required for new fabrication. The case report shows a non-described screw fracture of a PSI-TMJ fossa and the first description of a temporary revision using a PSI-TMJ fossa made of bone cement.

Indications for alloplastic temporomandibular joint replacement in maxillofacial trauma—an analysis of condylar trauma patients with scoping review of the literature

“…In summary, a total of 13 publications including 16 patients were identified by the various search approaches and included in the review (Table 3) (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Four of the patients received an alloplastic reconstruction other than a total joint replacement as a primary treatment following a condylar fracture (36)(37)(38).…”

“…The application of a total TMJR was found exclusively as a secondary treatment option for condylar fractures. In 9 cases TMJR was done within a time frame greater than 6 months post fracture (39,(42)(43)(44)(45)(46)(47)(48). Therefore, only three patients (secondarily treated with TMJR within 6 months post fracture) sufficiently met the PICOTS criteria (39)(40)(41).…”