# Accuracy and Safety of Computer-Assisted Surgery (CAS) in the Treatment of TMJ Ankylosis—Report of Several Cases and Review of the Literature

## TL;DR

This paper examines how computer-assisted surgery improves accuracy and safety in treating TMJ ankylosis, based on case reports and a literature review.

## Contribution

The study introduces a comparative analysis of 3D-printed guides and navigation systems for TMJ ankylosis surgery.

## Key findings

- 3D surgical cutting guides accurately guided osteotomy depth and position but had issues with angulation control.
- Navigation guiding maintained planned thickness of the skull base and external auditory canal effectively.
- Three cases of intraoperative complications were reported, highlighting the challenges in resecting the ankylotic mass.

## Abstract

Background: Temporomandibular joint (TMJ) ankylosis is an uncommon condition in the modern world, yet it remains a significant treatment challenge. One of the main intraoperative difficulties is accurately and safely resecting the ankylotic mass. Objective: This study seeks to share our clinical experience with various types of complications and to review the literature on the clinical and technological evidence regarding the accuracy of surgical detachment of the ankylotic mass from the skull. Methods: A literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Search strategies were categorized into search 1 for evaluating 3D-printed technology and search 2 for computer-assisted surgical navigation. Results: One study was selected for search 1 and 2 for search 2. Also, three cases of intraoperative surgical complications associated with the resection of the ankylotic mass were presented. The 3D surgical cutting guides were found to be accurate in guiding the superior, inferior, and depth of the osteotomy. Angulation control was less than optimal. Navigation guiding proved accurate in maintaining the planned thickness of the skull base and the anterior wall of the external auditory canal. Conclusion: Navigation guiding is a superior method for achieving predictable anatomical resection of the ankylotic mass.