Customized Bilateral Condylar Reconstruction Associated with Orthognathic Surgery in a Patient with Juvenile Idiopathic Arthritis: Case Report

Abstract Juvenile idiopathic arthritis (JIA), also referred to as juvenile rheumatoid arthritis, is a chronic autoimmune inflammatory condition that, when affecting the temporomandibular joint (TMJ), can lead to severe changes, including condylar resorption. This paper aims to report a clinical case of functional and aesthetic rehabilitation through the placement of customized condylar prostheses combined with orthognathic surgery. A 33-year-old female patient with a history of juvenile rheumatoid arthritis presented with skeletal open bite, mandibular retrognathia, and complete condylar resorption. Virtual surgical planning enabled precise simulation of the outcome and guided the execution of the procedure, which included mandibular advancement, midline correction, genioplasty, placement of condylar prostheses, and maxillary segmentation. Postoperative recovery was stable and uneventful, with functional restoration of the mandible, satisfactory occlusion, and significant facial aesthetic improvement. It is concluded that the integrated approach using customized condylar prostheses and orthognathic surgery offers safe and effective results for patients with severe TMJ involvement.