Rhee Seung-Hyun, Baek Seung-Hak, Park Sang-Hun, Kim Jong-Cheol, Jeong Chun-Gi, Choi Jin-Young
1Department of Oral and Maxillofacial Surgery, Seoul National University, Dental Hospital, Seoul, South Korea.
2Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of South Korea.
Maxillofac Plast Reconstr Surg. 2019 Oct 10;41(1):41. doi: 10.1186/s40902-019-0225-1. eCollection 2019 Dec.
The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses.
A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication.
For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.
本研究的目的是探讨使用三维（3D）虚拟手术规划、计算机辅助制造（CAD/CAM）制作的手术导板和库存颞下颌关节（TMJ）假体，对双侧颞下颌关节复发性强直患者进行全关节重建手术。
一名66岁女性患者，有多次颞下颌关节手术史，主诉进食严重困难和牙关紧闭。使用虚拟手术软件（FACEGIDE，韩国大邱MegaGen种植体公司）进行3D虚拟手术。在确认颧骨根部切除上缘位置、强直髁突切除下缘位置以及库存TMJ假体（美国佛罗里达州杰克逊维尔Biomet公司）的窝和髁突部件位置后，采用CAD/CAM技术制作手术导板。在全身麻醉下，根据手术规划进行截骨并植入库存TMJ假体（Biomet）。术后2个月，患者能够张口至30毫米，无并发症。
对于双侧颞下颌关节复发性强直患者，使用3D虚拟手术规划、CAD/CAM制作的手术导板和库存TMJ假体进行全关节重建手术可能是一种有效的手术治疗选择。
