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Heterotopic Ossification Around Temporomandibular Joint Prosthesis: Case Report and a Scoping Review

Nour Jihad Salman*, Guilherme dos Santos Trento, Pedro Henrique de Azambuja Carvalho, Marisa Aparecida Cabrini Gabrielli, Mário Francisco Real Gabrielli, Eduardo Sant’Ana, Valfrido Antonio Pereira Filho

Bone formation in tissues without ossification properties such as muscles and connective tissues can be defined as Heterotopic Ossification (HO). It is a relevant issue for surgeons performing TMJ reconstruction with TMJ prostheses. The objective of this study was to analyze and compare previous literature findings regarding etiology, diagnosis, prophylaxis and further treatment and management of heterotopic bone formation around TMJ prostheses. Besides, a 16-year-old male clinical-case with 19-years follow-up is reported. The search strategy of this scoping review was performed in three different databases (MEDLINE, ELSEVIER and Cochrane) by three independent reviewers (NJS, GST, PHAC), the selection and analysis of the scientific articles was performed according to the following criteria: Specific studies that evaluated the presence of heterotopic bone formation in TMJ prosthesis; studies on humans and reported in English language. This study provides qualitative and quantitative reviews of information regarding etiology, diagnosis, prevention, and management of HO around TMJ prostheses. Several management protocols were proposed, ranging from simple HO resection and prosthesis removal to autologous fat graft and low dose radiation therapy, with varying success rates. Nevertheless, further investigation is required to formulate a standardized prevention/management protocol to aid surgeons obtain long-term success in TMJ replacement procedures in the future.