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HOFFMAN-PAPPAS TEMPOROMANDIBULAR JOINT REPLACEMENT SYSTEM*
 

Temporomandibular Joint (TMJ) Surgical Procedure
By David Hoffman DDS

  • A retromandibular incision is utilized to gain exposure to the ramus.
  • Expose ramus as high as possible.
  • A pre-auricular incision is utilized to gain expose to the condylar head and fossa.
  • The condylar head is exposed through the pre-auricular incision.
  • The condylar head is resected at the level of the sigonoidl notch. The fossa is cleaned and surface irregularities are removed.
  • The fossa component is placed and stability is checked. There should be no rocking or tilting of the component.
  • The fossa component is removed and the ultra-high molecular weight polyethylene bearing is inserted into the fossa component. The assembled prosthesis is placed back into position.
  • The ramus component is placed through the retromandibular incision and fit is checked. It is important to place the component so as to avoid the mandibular nerve.
  • Sponges are packed into both incision and the mouth is isolated. The patient is placed in maxillomandibular fixation (wire teeth together) so proper positioning of the implants and mouth can be obtained.
  • Return to incisions to fixed prosthetic components. The fossa is fixed with four 2.0 mm x 6 or x 8mm screws. The ramus component is fixed next with 2 mm screws and 3.5 mm anti-micro motion locking screws.
  • Incisions are closed in a normal layered fashion. The maxillomandibular fixation is removed and the patient is checked for ROM.

*Available only under clinical investigation in the United States

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