Work

Intraoral Approach for Mandibular Resection with TMJ Disarticulation: Outcomes from a Case Series

Year: 2026

Type: article

Abstract: ABSTRACT Objective: To describe the tactical alterations that allow the use of the intraoral approach for resection of mandibular tumors requiring TMJ disarticulation. Material and Methods: Six patients with extensive mandibular lesions requiring temporomandibular joint disarticulation were treated using an intraoral surgical approach. This case series, describes step by step, the intraoral approach for resection of a mandibular tumor with unilateral temporomandibular joint disarticulation. The incision should be made in the vestibular and lingual mucosa and in an anatomical region that guides mucoperiosteal detachment for adequate lesion exposure. An anterior osteotomy enables segment rotation for lingual region access. Segmentation in the retromolar region and coronoidectomy can facilitate disarticulation and allow tumor removal in two stages in extensive lesions crossing the mandibular midline. Results: The intraoral approach provides adequate visualization and facilitates TMJ disarticulation while preserving facial aesthetics and soft tissue integrity. Compared with extraoral access, this method minimizes visible scars and preserves recipient-site vascularization, which is essential for graft survival in mandibular reconstructions. Conclusion: This technique is described to guide intraoral mandibular tumor resections, aiming to reduce aesthetic alterations, decrease morbidity, mitigate the chances of injury to the marginal mandibular nerve, and ensure greater vascularization of the region.

Source: Pesquisa Brasileira em Odontopediatria e Clínica Integrada

DOI: 10.1590/pboci.2026.143