Evaluation of Prosthetic TMJ Positioning Using Intraoperative C-Arm in Unilateral TMJ Replacement Surgery: A Technical Note

Temporomandibular joint reconstruction (TMJR) with standard alloplastic prosthesis is a reliable treatment for TMJ ankylosis, especially for recurrent cases.

Long-standing TMJ ankylosis causes morphological changes in the mandible, resulting in ill adaptation of stock TMJ prosthesis over the ramus of the mandible with mediolateral and anteroposterior discrepancy. It makes it cumbersome for the surgeon to adapt the stock prosthesis to an ideal position during the procedure. In unilateral TMJ replacement surgery, the mediolateral inclination of the mandibular component cannot be appreciated under direct vision.

An intraoperative C-arm was used to visualize, compare and confirm the accurate mediolateral and anteroposterior position of stock TMJ prosthesis in unilateral total TMJ replacement, thereby placing the condylar unit in a near-ideal position. Various positions of C-arm were discussed.

The practice of intraoperative C-arm usage has helped the operating surgeon's ambiguity concerning the near-accurate three-dimensional position of the new condyle within the fossa.