Custom Anatomical 3D Spacer for Temporomandibular Joint Resection and Reconstruction

Craniomaxillofacial Trauma & Reconstruction
John Marshall GreenGerald Thomas Grant

Abstract

Two cases are presented using a two-stage approach and a custom antibiotic spacer placement. Temporomandibular reconstruction can be very demanding and accomplished with a variety of methods in preparation of a total joint and ramus reconstruction with total joint prostheses (TMJ Concepts, Ventura, CA). Three-dimensional reconstructions from diagnostic computed tomography were used to establish a virtually planned resection which included the entire condyle-ramus complex. From these data, digital designs were used to manufacture molds to facilitate intraoperative fabrication of precise custom anatomic spacers from rapidly setting antibiotic-impregnated polymethyl methacrylate. Molds were manufactured using vat polymerization (stereolithography) with a photopolymer in the first case and powder bed fusion (electron beam melting) with Ti6AL4V for the second. Surgical methodology and the use of molds for intraoperative spacer fabrication for each case are discussed.

References

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Oct 29, 2002·Journal of Orthopaedic Surgery·Steven Gitelis, Gregory T Brebach
Jul 9, 2005·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·N M GoodgerBradford Hepworth
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Citations

Feb 23, 2017·The Journal of International Medical Research·Xiang RenXiao-Jun Duan
Apr 20, 2017·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Trevor D CraftsAvinash V Mantravadi
Feb 3, 2018·International Journal of Molecular Sciences·Xavier Van BellinghenFlorence Fioretti
Feb 19, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sumit KumarRanjit K Patil
Jul 10, 2021·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·Marcus TeschkeHendrik Naujokat
Jul 13, 2021·Journal of Materials Research·Georges E DaoudKyle K VanKoevering

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Methods Mentioned

BETA
biopsy
dissection
electron beam

Software Mentioned

Magics
FreeForm Modeling Plus
MIMICS
Materialise

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