PDF: TMJ Total Joint Prosthesis for Condylar Fracture Malunion

A 54-year-old man with history of condylar fracture 16 months ago was referred with limitation of mouth openning and pain. 

Intraoral examinations showed a patient with a severely periodontal disease and treatment with implants and dental prosthesis related to infection and implant mobility.

The patient had less than 15 mm interincisal distance in open mouth and showed pain related to mandibular fracture treated previously. 

Previously to TMJ treatment all remaining teeth and implant were removed due to periodontal disease for further rehabilitation using a new dental implants installed in an adequately position with good bone support.

Computed tomography (CT) confirmed condylar fracture malunion by failure of the internal fixation.

In the international literatura exist some information related to temporomandibular joint (TMJ) involvement in condylar fracture malunion; the treatment is variated being executed with a bone reconstruction, ramus vertical osteotomy or condilar plate.

This case demonstrates that TMJ replacement with prosthetic joint is technically possible and appropriate in the case of malunion of condylar fracture.