Surgical-orthodontic management of persistent closed lock of the TM joints

Surgical management of internal derangement in the temporomandibular joint traditionally involves disk repair or removal. Disks are often replaced with various types of autogenous, allogenic or alloplastic materials. The failure rates for such replacements are estimated at 10% to 20%. Current thinking suggests that permanent alloplastic interpositional grafts should be avoided. The following report describes the orthodontic/orthognathic surgical management of a patient with bilateral Silastic fossa implants.