Treatment of calcium pyrophosphate deposition in the temporomandibular joint with resection and simultaneous reconstruction using a custom joint prosthesis

Oral Maxillofac Surg. 2020 Jun;24(2):235-238. doi: 10.1007/s10006-019-00825-7. Epub 2019 Dec 16.

Abstract

Purpose: The authors present a rare case of calcium pyrophosphate deposition disease (CPPD) in the temporomandibular joint (TMJ), successfully treated with complete resection and immediate reconstruction using a custom-made prosthesis. This one-stage approach has prevented the patient from requiring two surgeries and has proven effective in the management of the condition.

Methods: Our patient, a 56-year-old male, presented with left TMJ pain and trismus. Investigations showed a destructive left TMJ mass, confirmed by biopsy to be tophaceous pseudogout. The treatment involved excising all the affected tissues followed by condylectomy, coronoidectomy, and a total TMJ replacement. The patient recovered well from surgery with good mouth opening.

Results: CPPD disease is a metabolic arthropathy of poorly understood aetiology. Management options vary from conservative non-surgical to surgical treatment depending on the severity.

Conclusion: This case demonstrates the feasibility of a one-stage procedure with reconstruction using a custom-made prosthesis and virtual planning.

Keywords: Calcium pyrophosphate; Custom-made prosthesis; Pseudogout; Temporomandibular joint.

Publication types

  • Case Reports

MeSH terms

  • Calcium Pyrophosphate
  • Chondrocalcinosis*
  • Humans
  • Joint Prosthesis*
  • Male
  • Middle Aged
  • Temporomandibular Joint
  • Temporomandibular Joint Disorders*

Substances

  • Calcium Pyrophosphate