Mandibular Notch Contouring in Temporomandibular Joint Replacement. Technical Note.

Temporomandibular Joint Replacement (TMJ-R) is used to treat maxillomandibular disease related to condylar head augmentation, condylar head reduction, absence of the condylar head and TMJ reconstruction. In most of the cases, TMJ-R could be used together with orthognathic surgery. In cases with facial asymmetry related to overgrowth of the mandibular condyle as in the cases of osteochondroma, there is a progressive facial asymmetry with enlargement of the unilateral mandibular ramus and mandibular body, creating strong mandibular contouring when comparing to the contralateral side. Usually, in this case, a lack is observed in the antegonial notch. ​The aim of this technical note ​is to provide the strategy to obtain facial symmetry using the TMJ prosthesis and contouring osteotomy in the same procedure.