Middle-Term Follow-Up Outcomes of the Customised Temporomandibular Joint-Skull Base Combined Prosthesis by 3D Printing

Introduction: The combined lesions of the temporomandibular joint (TMJ) and skull base pose a considerable clinical challenge, frequently necessitating complex reconstructive procedures, yet established treatment protocols remain insufficient. This case series aims to assess the middle-term clinical safety, accuracy, and efficacy of our own customised temporomandibular joint-skull base combined prosthesis by 3D printing. Methods: This is a prospective single-centre consecutive case series study and planned to enrol 12 patients. Patients with TMJ-skull base combined lesions who visited the Department of Oral Surgery of our hospital from September 2016 to April 2024 were recruited. General conditions, clinical examinations, and radiological evaluations were conducted preoperatively and at 1 month, 3 months, 6 months, 1 year, 2 years, and possibly beyond 3 years postoperatively. Computed tomography scans were used to assess prosthesis position and bone contact. The 10 cm visual analogue scale (VAS) was used to assess pain, diet, and mandibular function. Objective evaluations included maximum internal opening, deviation of opening, and maximum mandibular forward and lateral movement. SPSS software was employed for data analysis. Results: A total of 12 patients (6 females and 6 males, with an average age of 46.58 ± 12.17 years) were included; all patients underwent prosthesis implantation. After a follow-up period of 3.85 ± 2.63 years, patients showed no adverse symptoms such as infection and cerebrospinal fluid leakage. The occlusion and face type were stable. The prosthesis did not exhibit significant loosening, displacement, or fracture, and all had good bone integration. Postoperative pain, diet, mandibular function, and maximum internal opening underwent significant enhancement, whereas deviation of opening and mandibular movement towards the non-diseased side remained unchanged. Conclusion: The customised TMJ-skull base combined prosthesis developed in this study exhibited favourable mid-term clinical safety, accuracy, and efficacy in its application. Clinical relevance: Our findings offer promising prospects in and clinical translational value in terms of development of TMJ and skull base reconstruction technology in future.