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Review Article| Volume 19, ISSUE 2, P243-270, September 2011

Planning for Combined TMJ Arthroplasty and Orthognathic Surgery

  • Larry M. Wolford
    Correspondence
    Corresponding author. 3409 Worth Street, Suite 400, Dallas, TX 75246.
    Affiliations
    Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX, USA

    Private Practice at Baylor University Medical Center, Dallas, TX, USA
    Search for articles by this author
  • Amit Dhameja
    Affiliations
    Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX, USA

    Private Practice, Denton, TX, USA
    Search for articles by this author
DOI:https://doi.org/10.1016/j.cxom.2011.05.008
Planning for Combined TMJ Arthroplasty and Orthognathic Surgery
Previous ArticlePatient-Fitted (“Custom”) Alloplastic Temporomandibular Joint Replacement Technique
      Temporomandibular joint (TMJ) and dentofacial deformities commonly coexist. The TMJ disorders may be the causative factor of the jaw deformity or may have developed as a result of the jaw deformity, or the 2 entities may occur independently of each other. The TMJs form the foundation for jaw position, function, occlusion, facial balance, and comfort. If the TMJs are not stable and healthy (nonpathologic), patients requiring orthognathic surgery may have unsatisfactory outcomes relative to function, aesthetics, occlusal and skeletal stability, and pain. The most common TMJ disorders that can adversely affect orthognathic treatment outcomes include (1) articular disc dislocation, (2) adolescent internal condylar resorption (AICR), (3) reactive arthritis, (4) condylar hyperplasia, (5) ankylosis, (6) congenital deformation or absence of the TMJ, (7) connective tissue and autoimmune diseases, and (8) other end-stage TMJ disorders. These TMJ conditions are often associated with dentofacial deformities, malocclusion, TMJ pain, headaches, myofascial pain, TMJ and jaw functional impairment, ear symptoms, and sleep apnea. Patients with these conditions may benefit from corrective surgical intervention, including TMJ and orthognathic surgery. The difficulty for many clinicians is in identifying the presence of a TMJ condition, diagnosing the specific TMJ disorder, and selecting the proper treatment of that condition.
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      Further readings

        • Coleta K.E.
        • Wolford L.M.
        • Gonçalves J.R.
        • et al.
        Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part I–skeletal and dental stability.
        Int J Oral Maxillofac Surg. 2009; 38: 126-138
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        • Wolford L.M.
        • Gonçalves J.R.
        • et al.
        Maxillo-mandibular counter-clockwise rotation and mandibular advancement with TMJ Concepts total joint prostheses: part II–airway changes and stability.
        Int J Oral Maxillofac Surg. 2009; 38: 228-235
        • Goncalves J.R.
        • Cassano D.S.
        • Wolford L.M.
        • et al.
        Postsurgical stability of counterclockwise maxillomandibular advancement surgery: affect of articular disc repositioning.
        J Oral Maxillofac Surg. 2008; 66 (article 52949): 724-738
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        • Gerard H.C.
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        Reactive arthritis: preliminary microbiologic analysis of the human temporomandibular joint.
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        Efficacy of high condylectomy for management of condylar hyperplasia.
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        TMJ concepts/Techmedica custom-made TMJ total joint prosthesis: 5-year follow-up.
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        in: Booth P.W. Schendel S.A. Hausamen J.E. Maxillofacial surgery. vol. 2. Churchill Livingstone, St Louis (MO)2007: 1155-1210

      Article info

      Identification

      DOI: https://doi.org/10.1016/j.cxom.2011.05.008

      Copyright

      © 2011 Published by Elsevier Inc.

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