Total Joint Replacement for Immediate Reconstruction following Ablative Surgery for Primary Tumors of the Temporo-Mandibular Joint

Abstract

Temporomandibular joint (TMJ) tumors are rare and difficult to diagnose. The purpose of this retrospective study was to evaluate the clinicopathologic characteristics of twenty-one patients with primary TMJ tumors between 2010 and 2019 and to analyze the surgical outcome and morbidity after ablative surgery and TMJ replacement. This case series confirmed the difficulty of diagnosis and reaffirmed the need for early recognition and management of TMJ tumors. There were no pathognomonic findings associated with TMJ tumors, although single or multiple radiopaque or radiolucent areas were observed on plain or panoramic radiographs. Occasionally, bone resorption or mottled densities caused by pathologic calcification and ossification were seen. Computed tomography and magnetic resonance imaging played an important role in the diagnosis. In our study, the distribution of histologic types of TMJ tumors was quite different from that of other joint tumors. The recommended treatment was surgical intervention by ablation of the joint and TMJ replacement. The results of this retrospective study support the surgical exeresis and replacement with TMJ stock and custom-made prostheses and show that the approach is efficacious and safe, reduces pain and improves mandibular movements, with few complications.

Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication

“…Progressively, bone reconstructions with alloplastic material prostheses are becoming more popular in the maxillofacial surgery field, opening new scenarios and new reconstructive alternatives [6,20]. In temporomandibular joint pathology, ATMJR has been used for the management of end-stage temporomandibular diseases for over 2 decades with success, enhancing mandibular functionality (mastication, deglutition, and phonation) and improving quality of life [9,21,22].…”