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Development of a patient-specific TMJ prosthesis2519Fig. 5: Clinical visualization of the patient’s maximal mouth opening (a) and lateral movement towards the unoperated side. (b) after unilateral temporomandibular joint replacement.Case study #2: bilateral total joint replacement.A 77-year-old female patient underwent conservative treatment for bilateral arthrogenic TMJ pain that had persisted since 1986. In 2007, a CT scan showed an extensive degenerative process in both joints. In 2011, a CT scan showed extreme narrowing of the joint spaces and a dysmorphic appearance of the condyles, including osteophytic and resorptive processes. In 2017, she visited multiple hospitals with pain in both TMJs which, at rest, radiated temporally and worsened during movement. Her maximal mouth opening was restricted to 25 mm. VAS pain scores of 8/10 (right) and 6/10 (left) were obtained, which led to a VAS dietary score of 4 (where 0 is a liquid diet and 10 is a normal diet) and an overall Wilkes Stage 5 classification with variable pain at rest and crepitations and pain during movement.(22)Nikolas de Meurechy NW.indd 251 05-06-2024 10:14