title: Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.
abstract: Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery.
authors.affiliation: Current Fellow, Department of Orthognathic and Temporomandibular Joint Surgery, Baylor College of Dentistry, Texas A&M University System Health Science Center, Baylor University Medical Center, Dallas, TX.
authors.forename: Reza
authors.initials: R
authors.lastname: Movahed
authors.forename: Marcus
authors.initials: M
authors.lastname: Teschke
authors.forename: Larry M
authors.initials: LM
authors.lastname: Wolford
mesh_terms: D019643:Arthroplasty, Replacement / Q000379:methods*; D002508:Cephalometry; D002985:Clinical Protocols; D003198:Computer Simulation; D063169:Dentofacial Deformities / Q000150:complications / Q000601:surgery*; D006801:Humans; D008953:Models, Anatomic; D061646:Operative Time; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000601:surgery*; D013997:Time Factors