Success of custom total joint replacement simultaneous with orthognathic surgery in patients with idiopathic condylar resorption

Abstract

The aim of this study was to evaluate the aesthetic and functional outcomes of custom alloplastic total joint replacement combined with orthognathic surgery (cTJR + OS) in patients with idiopathic condylar resorption. Thirteen patients who underwent cTJR + OS between 2015 and 2022 were analysed retrospectively. Primary outcomes were maximum inter-incisal opening (MIO), scores for joint pain, jaw function, diet, sleep apnoea, and aesthetics. Secondary outcomes were cranial nerve VII deficits, infection, heterotopic ossification, prosthesis failure with need for reoperation, and bleeding. Clinical data were collected for a minimum 24 months post-surgery; postoperative data were compared with the preoperative data. Mean follow-up was 39.6 months. Significant improvements were observed in joint pain (P = 0.026), jaw function (P = 0.004), diet (P = 0.004), sleep apnoea (P = 0.001), and aesthetics (P = 0.001) scores, as well as in MIO (P = 0.006). The greatest improvements (preoperative to postoperative) were obtained for aesthetics and sleep apnoea, and the smallest for joint pain and MIO. Early and mid-term results were very satisfactory in terms of the patients’ perceptions of the outcomes investigated. Optimization of the prosthesis design and increasing surgical experience may contribute to significant improvements in patient outcomes.