Eminectomy performed through an innovative digital workflow.

Abstract

Eminectomy has been a well-established surgical procedure for the management of recurrent temporomandibular joint (TMJ) dislocation for over seven decades. This paper presents a digital workflow designed to enhance the surgical precision and safety of eminectomy. A 22-year-old female patient with recurrent TMJ dislocation underwent bilateral eminectomy. The patient's medical history included myasthenia gravis, which was considered in the surgical planning. A digitally designed cutting guide and depth template were created using Dolphin Imaging 11.95 software and subsequently produced via 3D-printing. The eminectomy was performed using a piezoelectric device, with the cutting guide ensuring a precise osteotomy and the depth template limiting bone removal to the necessary extent. The use of these digitally planned instruments facilitated a more efficient procedure compared to previous eminectomies performed by the same surgeon. Furthermore, the preoperative digital workflow enhanced the surgical safety by protecting the adjacent neurovascular structures through the customized cutting guide and depth template. In conclusion, digitally planned and 3D-printed surgical guides are valuable tools that may significantly improve the precision, efficiency, and safety of eminectomy.