[Custom-made implant for complex facial reconstruction: A case of total replacement of temporo-mandibular joint, zygomatic arch and malar bone].
BACKGROUND
Total prosthetic replacement of the temporo-mandibular joint (TMJ) has become a common procedure, but it is usually limited to the TMJ itself. We report about one case of complex prosthetic joint reconstruction extending to the neighbouring bony structures.


METHODS
A 57-year-old patient, operated several times for a cranio-facial fibrous dysplasia, presented with a recurring TMJ ankylosis and a complexe latero-facial bone loss on the right side. We performed a reconstruction procedure including the TMJ, the zygomatic arch and the malar bone by mean of custom made composite prosthesis (chrome-cobalt-molybdenum-titanium and polyethylene). Five years postoperatively, mouth opening, nutrition, pain and oral hygiene were significantly improved.


CONCLUSIONS
Nowadays technical possibilities allow for complex facial alloplastic reconstructions with good medium term results.
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
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D
Guillier
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
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V
Moris
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
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LA
See
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
M
M
Girodon
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
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BL
Wajszczak
Service chirurgie maxillo-faciale, plastique-reconstructrice et esthétique, chirurgie de la main, CHU de Dijon, boulevard de Lattre-de-Tassigny, 21000 Dijon, France; Lipids nutrition cancer team NuTox UMR866, university Bourgogne Franche-Comté, boulevard Jeanne-d'Arc, 21000 Dijon, France. Electronic address: n.zwetyenga@gmail.com.
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N
Zwetyenga
D000844:Ankylosis / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods*; D001848:Bone Diseases, Developmental / Q000150:complications / Q000601:surgery; D005145:Face / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D015050:Zygoma / Q000601:surgery*
Agenesis; Agénésie; Ankylose; Ankylosis; Articulation temporo-mandibulaire; Bone dysplasia; Dysplasie osseuse; Prosthesis; Prothèse; TMJ; Zygomatic; Zygomatique