As we know, the reconstruction plate and artificial condyle which we use in hemimandibulectomy are rigid comparing to the natural bone, where a fracture of condylar neck prevents this more serious injury.
Probably higher than a bone condyle, the regular or a bone graft. But, I never read a report of such complication with an artificial (metal) condyle. There are reports of metal condyle at the medial cranial fossa but not as a result of trauma.
the risk is high, not many have occured and reported because metal condylar head is placed much below the glenoid fossa compared to natural condyle in reconstruction of mandible.
And in TM joint cases, total TMJ recon unit is used .(total joint prosthesis)
Read the following reference:
Mercuri LG: Commentary: Condyle Replacement after Tumor Resection: Comparison of Individual Prefabricated Titanium Implants and Costochondral Grafts. Oral Surg 108: 153-155, 2009.
The recon plate is rigid and does not break easily. Whereas the fracture at the condylar neck is common after mandibular trauma. Therefore theoretically, the risk of the plate ending up in the middle cranial fossa is high in the event of facial trauma.
I have used recon plates in the reconstruction of hemimandible on many occasions.Sometimes I have used it purely without bone grafts as well. The recon plate breaks at some stage later due to masticatory forces. This happens mostly in patients who had just the plate for temporary reconstruction.
The shape of the plate is not as flat as the original condylar head. Thus the possibility of transfer of more force through the glenoid fossa.
Thank you everyone for sharing the knowledge and comments. I really appreciate it.
Prof Louis G.Mercuri : I read with interest the paper you've suggested. Though follow up period is quite short, but the custom titanium implant were favored as it can mimic normal anatomy and function. It was said can preclude glenoid fossa erosion as what was reported by Lindqvist’s study. Important factors are including preservation of as much capsule and surrounding tissue and secure it with purse-string suture.
I admit that I also had never read report of such complication (artificial condyle attached to re-con plate driven into middle cranial fossa due to trauma). Perhaps, precaution is what we always needed. The risk is there, especially if the glenoid fossa itself is eroded.
- Badges
- Science topic
- Similar topics
- Correction