A Protocol for the Use of a Combined Microvascular Free Flap with Custom-Made 3D-Printed Total Temporomandibular Joint (TMJ) Prosthesis for Mandible Reconstruction in Children

Extended postoperative mandibular reconstructions due to orofacial disease involving the temporomandibular joint (TMJ) in immature patients remain a challenge as result of ongoing growth, which is usually affected by and treatment. Current reconstructive techniques based fully on alloplastic total replacement fail meet anatomical functional requirements for masticatory system speech development. Fourteen children aged 12.6 ± 2.6 with tumors or congenital deformities affecting mandible TMJ were included study. Radical surgical treatment according our own protocol was performed through microvascular anastomotic flap reconstruction soft tissues bones, together custom replacements. Follow-up lasted 2–6 years. During follow-up, increases body (13% growth) ramus (12% observed, both related (p < 0.001). This first report concerning immediate adolescents that combines free vascularized graft individual prosthesis TMJ. The presented technique enabled optimal function TMJ, growth mandible, further rehabilitation patients. demonstrated be safe, reliable, provide good cosmetic outcomes.