Total temporomandibular mandibular joint alloplastic replacement as first line treatment for condylar fracture

The treatment of condylar fractures has been the subject of debate and controversy. Open reduction and internal fixation, along with closed reduction, are the 2 main treatment modalities when well indicated and performed. In specific situations, however, the success of both treatment modalities can be challenged by local or systemic conditions. Alloplastic total temporomandibular joint replacement (TMJR) with the current systems, Biomet and Stryker, has proven to be successful in the long-term. The authors present 2 cases and propose the consideration of TMJR as a first-line treatment for condylar fractures in the following situations: fractures older than 4 weeks; 2) elderly patients with severely dislocated or displaced condyles; 3) condylar dislocation into the cranial fossa; 4) maxillomandibular fixation is not a viable option.