Application of TMJ Prosthesis After Multicystic Ameloblastoma Resection: A Case Report

Abstract

Objectives Ameloblastoma treatment includes variable methods from conservative to radical. A radical treatment option needs to consider reconstructive procedures. Alloplastic joint prostheses which have been popular in recent years can be used. In this case report, we present a case who was rehabilitated with an alloplastic joint prosthesis after radical ameloblastoma treatment. Case Description A 64-year-old patient was referred to our clinic. In the radiological examination, a multicystic lesion extending from the corpus to the condyle of the right mandible was noticed. The biopsy procedure was applied under local anesthesia. The pathological examination result was ameloblastoma. Segmental resection of the relevant region and rehabilitation with a custom TMJ prosthesis in the region. The patient has been followed up for 5 months after the operation and is still being followed up. Conclusion After the TMJ prosthesis, we applied to our patient, our patient’s speech and chewing function were largely preserved. In addition, there were no cosmetic problems. Although applying TMJ prostheses is more expensive than other radical treatments, it contributes greatly to patient morbidity.

Keywords

• ameloblastoma
• reconstruction
• temporomandibular prosthesis

References

1. 1. Brad W. Neville, D. D. S., Douglas D. Damm, D. D. S., Allen DDS MSD, C. & Angela C. Chi, D. Oral and Maxillofacial Pathology. (Elsevier Health Sciences, 2015).
2. 2. Milman, T., Ying, G.-S., Pan, W. & LiVolsi, V. Ameloblastoma: 25 Year Experience at a Single Institution. Head Neck Pathol. 10, 513–520 (2016).
3. 3. Mercuri, L. G. Condyle replacement after tumor resection: comparison of individual prefabricated titanium implants and costochondral grafts. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology vol. 108 153–155 (2009).
4. 4. Sham, E. et al. Mandibular ameloblastoma: clinical experience and literature review. ANZ J. Surg. 79, 739–744 (2009).
5. 5. Hayden, R. E., Mullin, D. P. & Patel, A. K. Reconstruction of the segmental mandibular defect: current state of the art. Curr. Opin. Otolaryngol. Head Neck Surg. 20, 231–236 (2012).
6. 6. Carlson, E. R. Disarticulation resections of the mandible: A prospective review of 16 cases. J. Oral Maxillofac. Surg. 60, 176–181 (2002).
7. 7. Fernandes, R., Fattahi, T. & Steinberg, B. Costochondral rib grafts in mandibular reconstruction. Atlas Oral Maxillofac. Surg. Clin. North Am. 14, 179–183 (2006).
8. 8. Medra, A. M. M. Follow up of mandibular costochondral grafts after release of ankylosis of the temporomandibular joints. Br. J. Oral Maxillofac. Surg. 43, 118–122 (2005).

9. 9. Quinn, P. D. & Granquist, E. J. Atlas of Temporomandibular Joint Surgery. (John Wiley & Sons, 2015).
10. 10. Kashi, A., Saha, S. & Christensen, R. W. Temporomandibular joint disorders: artificial joint replacements and future research needs. J. Long Term Eff. Med. Implants 16, 459– 474 (2006).
11. 11. Mercuri, L. G. Alloplastic temporomandibular joint reconstruction. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 85, 631–637 (1998).
12. 12. Kryshtalskyj, B. Total prosthetic joint replacement for the end-stage of TMJ disease. Ont. Dent. 67, 25, 27–9 (1990).
13. 13. Wolford, L. M., Mercuri, L. G., Schneiderman, E. D., Movahed, R. & Allen, W. Twenty-Year Follow-up Study on a Patient-Fitted Temporomandibular Joint Prosthesis: The Techmedica/TMJ Concepts Device. Journal of Oral and Maxillofacial Surgery vol. 73 952–960 (2015).