PMC6742675_01
(A) Patient at the age of 8 years. (B) Patient at the age of 16 years.
gr1.jpg
PMC6742675_01_gr1.jpg
fig0005
A gap arthroplasty was performed on the left side, however the patient returned a year later with bilateral TMJ reankylosis (Fig. 1).
(A) Pre-operative attempted mouth opening at age 8 years. (B) Pre-operative attempted mouth opening at age 16 years.
gr2.jpg
PMC6742675_01_gr2.jpg
fig0010
Fig. 2A and B show pre-operative mouth opening at 8 year and 16 years.
(A) Pre-operative radiographs at age 16 years: postero-anterior (mandible). (B) Orthopantomography. (C) Coronal CT scan.
gr3.jpg
PMC6742675_01_gr3.jpg
fig0015
Radiographic investigation included PA mandible (Fig. 3A), orthopantomogram (Fig. 3B) and coronal CT Scans (Fig. 3C).
3D images showing preoperative image and Virtual Surgical Planning for orthognathic surgery and custom joints.
gr4.jpg
PMC6742675_01_gr4.jpg
fig0020
TMJ reconstruction with custom joints was planned. The procedure and custom-made prostheses were planned using 3D imaging and stereolithic model generated from his CT scan (Fig. 4).
(A) Biomet Microfixation patient-matched alloplastic TMJ prostheses. (B) Intra-operative image of placement of TMJ prostheses.
gr5.jpg
PMC6742675_01_gr5.jpg
fig0025
Temporomandibular joints were reconstructed with Biomet Microfixation patient-matched alloplastic TMJ prostheses (Fig. 5).
Intra-operative image of genioplasty.
gr6.jpg
PMC6742675_01_gr6.jpg
fig0030
Facial asymmetry, occlusal plane cant and cross-bite were corrected with Le fort I osteotomy and a genioplasty (Fig. 6).
(A) Post-operative images depicting good facial symmetry. (B) Good maximum mouth opening. (C) Radiograph showing alloplastic joint prostheses.
gr7.jpg
PMC6742675_01_gr7.jpg
fig0035