Treatment of heterotopic ossification developing around total alloplastic temporomandibular joint prosthesis: case report

Abstract

Introduction: Total joint replacement applied in temporomandibular joint (TMJ) ankylosis improves function in the early period and significantly reduces the likelihood of reankylosis. However, reankylosis may rarely occur due to heterotopic bone formation around the TMJ prosthesis. In this situation, the bone mass is resected and the prosthesis is repositioned in the proper position. It has been reported in previous studies that the application of fat graft to the articular surfaces after the ankylosis surgery improves functionality and reduces the likelihood of reankylosis. Case Report: A patient with total alloplastic TMJ prosthesis that had been applied due to ankylosis of the left TMJ was admitted to our clinic with complaints of pain and limitation in mouth opening. Heterotopic bone formation around the TMJ prosthesis was observed through clinical and radiological examinations. Under general anesthesia, the TMJ prosthesis was exposed via preauricular approach. The TMJ prosthesis was removed atraumatically and the heterotopic bone mass was resected. The TMJ prosthesis was then placed in the appropriate position and autogenous fat graft was applied to the articular surfaces. No signs of reankylosis were observed during a two-year follow-up. Conclusion: Autologous interpositional fat graft applied after the resection of the bone mass in cases which develop reankylosis reduces the likelihood of recurrence, and improves jaw functions.

Keywords

• Ankylosis
• heterotopic ossification
• temporomandibular joint