Precision in Complexity: Efficacy of VSP and Mock Surgery in Stock Prosthetic Reconstruction for TMJ Re-Ankylosis

Introduction: Temporomandibular joint ankylosis (TMJA) management has evolved from gap arthroplasty to total joint replacement (TJR). TMJ re-ankylosis presents a significant challenge in achieving long-term treatment success. This study evaluates the effectiveness of virtual surgical planning (VSP) guided stock TJR in TMJ re-ankylosis. Materials and methods: Prospective, single-arm clinical interventional study with 10 patients (mean age 20.3 ± 1.37 years, range 18–28 years; 5 males, 5 females) with TMJ re-ankylosis were prospectively evaluated. Preoperative workflow integrated VSP for 3D mass assessment, cutting guide fabrication, and ramal osteoplasty mapping, followed by physical 1:1 stereolithographic mock surgery validation prior to alloplastic stock TJR (OrthoMax®). Functional outcomes were analyzed over a mean follow-up of 60 months. Result: This study showed statistically significant improvement in maximum interincisal opening (MIO) from 1.83 mm to 37.83 mm (p < 0.001), bite force from 0 kg to 10.31 kg (p < 0.001), masticatory efficiency, and diet consistency post-stock-TJR with a mean follow-up of 60 months. Mandibular range of movements and quality of life improved markedly with minimal postoperative complications. Conclusions: This study highlights the clinical success of the dual validation protocol by integrating VSP-guided stock-TJR in TMJ re-ankylosis. Mock surgery verified digital precision with intraoperative flexibility, ensuring optimal prosthesis fit, restored mandibular function, improvement in quality of life (QoL) and functional rehabilitation. With ongoing advancements, the VSP-guided stock-TJR protocol can be considered effective in TMJ re-ankylosis.