Robotic assisted lateral arthroplasty for temporal mandibular joint ankylosis: a preliminary study

BACKGROUND: This study aimed to preliminarily evaluate the feasibility, precision, and clinical efficacy of a novel robotic-assisted surgical approach specifically tailored for lateral gap arthroplasty in type III temporomandibular joint (TMJ) ankylosis. METHODS: Three patients diagnosed with bilateral type III TMJ ankylosis underwent robotic-assisted lateral gap arthroplasty. All patients received a fully digital treatment plan including 3D reconstruction, virtual osteotomy simulation, followed by fabrication of patient-specific metallic surgical guides. The depth and angulation of each osteotomy were meticulously designed and executed using robotic assistance to ensure high accuracy. Intraoperatively, surgical safety and immediate outcomes were assessed. Postoperatively, computed tomography (CT) scans were used to compare the actual surgical results with the preoperative plan, and the mean 3D deviation of cranial and mandibular structures was measured. RESULTS: All three patients achieved satisfactory clinical outcomes without complications. Intraoperative assessments confirmed complete removal of lateral bony masses, preservation of medial condyles, and no damage to adjacent anatomical structures. All patients demonstrated intraoperative maximal mouth openings exceeding 35 mm. Postoperative CT comparisons revealed osteotomy deviations of less than 1.5 mm from the preoperative plans. CONCLUSION: This study demonstrates that a robotic-assisted lateral gap arthroplasty, integrated with a comprehensive digital workflow including virtual surgical planning and 3D-printed guides, is feasible and safe, and shows considerable promise in improving surgical precision, standardization, and clinical outcomes for type III TMJ ankylosis.