Computer-assisted condylar reconstruction in bilateral temporomandibular joint ankylosis using autogenous coronoid process

Objective To describe the use of computer-assisted three-dimensional surgical planning in condylar reconstruction in patients with bilateral temporomandibular joint ankylosis using autogenous coronoid process and to explore its clinical effects.Methods Eight patients with bilateral temporomandibular joint bony ankylosis who visited our hospital from 2007 to 2009 were treated by bilateral ankylosed blocks resection and condylar reconstruction by free grafting of autogenous coronoid process with three-dimensional simulation using Surgicase CMF Materialise software.Clinical examination,radiograph,photograph,and details of operation and outcome were evaluated postoperatively to determine the clinical effects of the technique.Results Satisfactory mouth opening and occlusion were achieved in all cases.Radiographic examination showed that transplanted coronoid processes were all located in the mandibular fossa.Some bone resorption of the grafted coronoid process was observed,but no apparent occlusal changes were noted.Neither recurrence nor other obvious complication occurred.Conclusion Computer-assisted three-dimensional surgical planning and simulation combined with free grafting of autogenous coronoid process may be a suitable alternative to the reconstruction of condyles for patients with bilateral temporomandibular joint ankylosis,making the operation more accurate and more convenient.