Clinical case

Bilateral TMJ total joint replacement

Bilateral TMJ total joint replacement


This 25 year old woman presented with a convex facial profile, mastication disability because of an open bite malocclusion, intractable joint pain over more than one-year period and mental depression. She had a mouth opening of 19 mm. The reason was severe bilateral condylar resorption after orthognathic surgery on August 2009.

The recommended treatment, was a bilateral total joint replacement. In consultation with the treating surgeon, CADskills designed and manufactured the patient specific TMJ prostheses.

Besides achieving a normal mouth opening and reduction of pain, targeted ossification for enthesis reconstruction and reduction of unwonted calcifications were extra goals. This was  mandatory to obtain cutting & grinding (protraction and lateral movement, hence normal mastication) functions.

The patient received bilateral extended total joint replacement with mandibular repositioning on May 3, 2018. On September 4, she had a normal dental occlusion, no pain, a mouth opening of 36mm, and lateral movements allowing for normal mastication.