Orthognathic surgery in instability of the TMJ using surgical guides and customized plates: 3 case reports
Issued Date
2026-06-01
Resource Type
ISSN
24688509
eISSN
24687855
Scopus ID
2-s2.0-105025659067
Pubmed ID
41421599
Journal Title
Journal of Stomatology Oral and Maxillofacial Surgery
Volume
127
Issue
3
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Stomatology Oral and Maxillofacial Surgery Vol.127 No.3 (2026)
Suggested Citation
Boonsiriseth K., Naknual N., Puncreobutr C., Themkumkwun S. Orthognathic surgery in instability of the TMJ using surgical guides and customized plates: 3 case reports. Journal of Stomatology Oral and Maxillofacial Surgery Vol.127 No.3 (2026). doi:10.1016/j.jormas.2025.102689 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114647
Title
Orthognathic surgery in instability of the TMJ using surgical guides and customized plates: 3 case reports
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Corresponding Author(s)
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Abstract
Purpose: Patients with facial deformities and temporomandibular joint (TMJ) instability present unique challenges in orthognathic surgery (OGS). This report presents three complex cases of syndromic or post-traumatic deformities treated with virtual surgical planning (VSP), surgical guides, and customized fixation plates. Methods: Three patients with syndromic or post-traumatic deformities and TMJ instability underwent OGS. Planning was performed using Dolphin Imaging software. Surgical guides and patient-specific plates were designed with CAD software and fabricated via selective laser melting. Surgical workflows incorporated bone- and tooth-borne guides, with fixation achieved using customized titanium plates. Postoperative accuracy was evaluated by superimposing pre- and postoperative computed tomography (CT) scans. Results: Superimposition analysis revealed maximum surface deviations of less than 2 mm in all patients, with the maxilla demonstrating superior accuracy (<1 mm). Clinically, all patients showed improved facial symmetry, occlusion, and profile. The use of surgical guides and customized plates enhanced intraoperative precision and reduced the risk of root and nerve injury. Conclusion: Guided surgery with customized fixation improve surgical accuracy and outcomes in patients with complex deformities and TMJ instability. These results support the application of surgical guides and customized plates in challenging orthognathic cases.