Reconstruction of Lateral Capsular Ligament of Temporomandibular Joint with E-PTFE(Gore-tex(R)) Patch

ABSTRACT

The lateral capsular ligament of temporomandibular joint(TMJ) prevents mandibular condyle from lateral displacement in case of fractures related with condyle. When the condylar fracture with lateral extracapsular displacement occurs, open reduction and reconstruction of capsular ligament must be considered. However, many patients exhibit limitation of functional movements of the TMJ after such surgery. This may be a result of myositis, myospasm, fibrosis of bilaminar zone, adhesion of TMJ capsule. When the joint problem occurs, non surgical treatment must be attempted firstly. But if it fails, the surgical reconstruction must be considered. We reconstructed the lateral capsular ligament of TMJ with E- PTFE(Expanded Polytetrafluoroethylene, Gore-tex(R)) patch after removing scar tissues and adhesions. This surgical method showed improvements in movement as well as the pain of the joint. No side effect has detected from occlusion for about 2 years. There was no foreign body reaction or irritation to the capsule, since E-PTFE was biologically inert. We believe that the E-PTFE patch could be used as primary material of capsular ligament of TMJ reconstruction, insertion material in high tensioned capsule and reinforcement material in weakened capsule.