A new surgical technique for reduction of chronic recurrent luxation of the temporomandibular joint

Abstract

Abstract Introduction: The variety of approaches to the mandibular joint and the multiplicity of different surgical techniques proposed for reducing a chronic recurrent luxation of the temporomandibular joint (TMJ) over the past decades show the complexity of the surgical approach and reveal that an adequate technique is still lacking. Therefore, this paper describes a different surgical approach for a new augmentation technique of the articular eminence by inserting titanium implants into the zygomatic arch root.Materials and Method: Eight cadavers of the Department of Anatomy of the Medical University Graz embalmed with Thiel’s method were chosen due to their hypermobility of the TMJ and were investigated bilaterally. Each cadaver underwent a preoperative computed tomography (CT) for excluding any morphological derangements (tumor masses; fractures) of the TMJ and for determining implant length and implant diameter. The zygomatic arch root was visualized via preauricular access and the planned implants were inserted according to the drilling protocol of Dentsply Sirona. A postoperative Ct-scan was taken to recognize injuries of the mandibular joint. Results: In all cases a significant (p<0.001) reduction of translational movement with an adequate mouth opening (postoperative/mean value 43.1mm/SD 3.5mm) was achieved. The postoperative CT-scan showed that none of the zygomatic arch roots fractured after treatment and none of the mandibular condyles were injured by an implant.Conclusion: The proposed surgical technique shows promising results regarding surgical approach and clinical outcome.