A novel technique of total joint replacement in combination with a prominent mandibular advancement using 3D printing technology

TMJ ankylosis is a pathologic condition that interferes with mastication, esthetic, speech, oral hygiene, and normal life activities. The final purpose in treatment of TMJ ankylosis is restoring its function by reconstruction and replacement of the joint. A case of recurrent bilateral TMJ ankylosis post childhood trauma in a 19 years old male patient will be presented in this article. Patient had undergone multiple surgeries before, Nonetheless re-ankylosis happened subsequently. In addition to mandibular growth deficiency due to early childhood trauma, the range of mouth opening was as minimal as 2 mm which had caused malnutrition and severe weight loss. In this Novel technique we tried to imply the most recent technologies to compensate the growth deficiency and improve patient mouth opening. Hence, by using computer assisted planning and customized 3D printing technology a bilateral joint was designed and printed by 3D printer, known as total joint replacement surgery. Finally, in this single step surgery a 25 mm mandibular replacement was gained in addition to treatment of ankylosis and adjusting the position of condyles and mandible. The surgery outcome was a significant improvement in patient appearance, speech and masticatory function.