Mandibular Notch Contouring in Temporomandibular Joint Replacement. Technical Note

Temporomandibular Joint Replacement (TMJ-R) is used to treat maxillomandibular disease related to condylar head augmentation, condylar head reduction, absence of the condylar head and TMJ reconstruction. In most of the cases, TMJ-R could be used together with orthognathic surgery. In cases with facial asymmetry related to overgrowth of the mandibular condyle as in the cases of osteochondroma, there is a progressive facial asymmetry with enlargement of the unilateral mandibular ramus and mandibular body, creating strong mandibular contouring when comparing to the contralateral side. Usually, in this case, a lack is observed in the antegonial notch. The aim of this technical note is to provide the strategy to obtain facial symmetry using the TMJ prosthesis and contouring osteotomy in the same procedure.