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Chapter 9252In 2019, she underwent bilateral total joint replacement with a customized TMJ Parametro prosthesis at the Universitair Ziekenhuis Brussel. Both left and right lateral pterygoid tendons were reinserted into the scaffold in the condylar neck of the corresponding mandibular components.(17)(Fig. 7) Her postoperative maximal mouth opening progressed from 15 mm (1 month postoperatively) to 32 mm (3 years postoperatively), while her laterotrusive motion to the right increased from 1.5 mm to 5 mm during the same period. Meanwhile, the opposing laterotrusive motion increased from 1.5 mm to 3 mm. The results from her current followup of her maximal mandibular movements during this 3-year period are shown in Figure 6b. At the 1-month postoperative check-up, her pain had already completely disappeared (VAS pain score of 0, Fig. 6b), and after the 6-month mark, she was finally able to eat solid food again. (Fig. 6b)DiscussionAbovementioned post-operative results, which mimic healthy biomechanical movements of the mandible, were achieved by extensive research and careful selection of the most suited biomaterials and features, which are being discussed here. The main limitation of this study is the currently small sample group and short follow-up. Moreover, the electromyographic results of lateral pterygoid muscle activity could not be monitored. It would be interesting to correlate such findings with various lateral pterygoid muscle enthesis reconstructions.Nikolas de Meurechy NW.indd 252 05-06-2024 10:14