Patient-specific arthroplasty guide in paediatric temporomandibular joint ankylosis management. An accuracy-based case series.

AIM: To evaluate the accuracy, safety, and short-term functional outcomes of a patient-specific arthroplasty guide for the management of paediatric Temporomandibular Joint Ankylosis (TMJ-A).

METHODS

A prospective case series study was conducted on 7 children with TMJ-A. Virtual surgical planning and CAD/CAM fabrication were used to design a patient-specific arthroplasty guide with narrower osteotomy slits (width 5 mm) to allow precise bone removal and improved condylar fit. Preoperative and postoperative tomographic scans were utilized to measure the procedural accuracy of the computer-assisted operation. Functional outcomes included complication rate and maximal interincisal opening (MIO).

RESULTS

All children achieved satisfactory intraoperative mouth opening (> 30 mm). No intraoperative injury to the skull base or neurovascular structures was encountered. A 2.36 ± 0.18° of SMA deviation was reported on the right side, and 1.90 ± 0.46° on the left SMA. Regarding the linear VRH, 1.57 ± 0.33 mm deviation was reported in the right side, and 0.95 ± 0.46 mm in the left ramus length. Good agreement between planned and postoperative measurements for both parameters. Temporary facial nerve weakness occurred in 1 patient, which resolved within 8 weeks.

CONCLUSION

Patient-specific arthroplasty guide with direction-dictating slits allowed accurate and safe gap arthroplasty in paediatric cohort, facilitating stable intraoperative and early postoperative outcomes. This technique may reduce surgical variability and improve safety in paediatric TMJ surgery.

TRIAL REGISTRATION: Retrospective registration was performed at clinicaltrials.gov [NCT07320911/2026-1-6].