A Case of Glenoid Fossa Fracture, Progressive Ankylosis, Total Joint Reconstruction with Alloplastic Prosthesis to Normalized Function Including Evaluation with F18-PET/CT–a Four Year Follow-up

Abstract

Temporomandibular joint replacement (TJR) with alloplastic prosthesis has shown promising long-term results in end stage joint disorders. We present a case of young woman with painful ankylosis that where reconstructed with TJR, due to a complex mandibular fracture with dislocation of the left condyle into the middle cranial fossa two years earlier. At the age of 18 the subject underwent a total joint replacement with custom-made alloplastic TMJ prosthesis. To determine the bone response and remodeling activity around the prosthesis, a F18 PET/CT-scan was used. No sign of increased remodeling or pathology were seen in the imaging after the reconstruction. Four years postoperatively the subject reports no pain and excellent jaw function.

Mandibular condyle dislocation into the middle cranial fossa with open reduction and reconstruction with glenoid fossa prosthesis. Unusual case report and literature review.

“…Only two of them (Rikhotso and Bobat in 2016 and Lindell and Thor in 2017) were reconstructed using a TMJ prothesis, and both were total alloplastic reconstruction, using a condyle and glenoyd fossa prosthesis with good results in a long term follow up. Our case is the first to use a partial TMJ prosthesis, reconstructing only the glenoid fossa and maintaining the condyle that had not been fractured, with good results in a follow up of 12 months 10,11 .…”

Superior Dislocation of the Mandibular Condyle into the Middle Cranial Fossa: A Comprehensive Review of the Literature

“…The selection of a reconstruction material should be based on the age of the patient, time elapsed between initial injury and treatment, and size of the defect. TMJ prostheses are becoming increasingly popular, and they were applied in four cases included in this review [72,76,90,93]. A recent systematic review concluded that TMJ prostheses are reserved for patients presenting with persistent pain, bony or fibrous ankylosis, or osteomyelitis after the primary closed or open treatment of mandibular condyle fractures [125].…”