Use of a digitally designed surgical template for minimally invasive temporomandibular joint surgery

Minimally invasive procedures such as arthroscopy and arthrocentesis are therapeutic options for internal derangement (ID) of the temporomandibular joint (TMJ). This article describes the results of a pilot study of a digital surgical template designed to facilitate these procedures. Materials and methods: Divisible, patient-specific digital templates were designed using cone beam computed tomography (CBCT) and optical facial scan data, then 3D printed and tested in a first clinical trial on three patients who underwent template-guided minimally invasive temporomandibular joint surgery (MITMJS) consisting of arthroscopy (three TMJs) or arthrocentesis (three TMJs). Results: The template design and clinical use proceeded as planned. All templates showed excellent fit and provided direct access to the upper joint space. No complications were observed for any of the surgeries. Conclusions: Template guidance can facilitate MITMJS. Divisibility is an important design feature, making it possible to remove or reposition the template during surgery, if necessary. The proposed inhouse workflow results in low-cost production. Keywords: surgical template, computer-assisted surgery, minimally invasive temporomandibular joint surgery