Surgeon FAQs

Q1 – How long does it take to make a set of TMJ Concepts implants?
A1 – The early phases of the process are the most important to assure a timely turnaround. If TMJ Concepts is waiting on the imaging required for model build, a hospital purchase order, the surgeon’s design approval or any other instructions before manufacturing, this may have an impact on our ability to complete your case. After we have received the model and PO, you will receive an estimated lead time.

Q2 – If I decide to do a staged procedure what can I do to reduce the time between the first and second-stage surgeries?
A2 – Be sure to notify TMJ Concepts well before your first-stage surgery, so we have the opportunity to discuss with you the specifics of your case and a potential first-stage surgery date. Sending in an order form weeks in advance of your first-stage will allow us to reserve a place in our production queue, and also allows us to start talking to your hospital about a purchase order ( Staged cases always take priority whether for ankylosis or implant revision. The goal with these cases should always be to get as much done as possible in stage one to make stage two easier. Thorough debridement of the surgical site, recontouring or remodeling of heterotopic bone, then establishing the desired post-op occlusion for the protocol scan will assure that we can proceed straight to implant design once the post stage one imaging arrives. As some of these staged cases can be quite complex, our clinical consultants are always happy to review pre-staged imaging and make recommendations regarding goals for the first-stage surgery.

Q3 – What screws do I use for the fossa and mandible?
A3 – 2.0mm screws are the standard on both the fossa and mandible with 2.3mm screws acting as the emergency screw. TMJ Concepts offers 2.0mm screws in 5mm to 16mm lengths and 2.3mm screws in 6mm to 16mm lengths. Every case has screw lengths measured at the time of final evaluation just prior to cleaning and packaging. Photos with recommended screw lengths are provided with every case for reference. Note, subtle variations in placement of the implant components and drill angle may require different screw lengths.

Q4 – Will I have the patient model at surgery for reference?
A4 – Every case is shipped to your hospital with the non-sterile model that was used for the case, unless you have made prior arrangements to have the model shipped to your office. Make sure to have it available at surgery for reference. The non-sterile model can often be essential to assure the components are placed as planned.

Q5 – Can I sterilize the model?
A5 – No, the model is not indicated to be sterilized.

Q6 – What do I do if my patient says they have material sensitivity to one or more of the implant materials?
A6 – TMJ Concepts may provide a limited quantity of all-titanium mandibular implants via the FDA’s compassionate use program for documented highly reactive material-sensitive patients. Please consult with us regarding ordering all-titanium implants for details on this process. Click here for detailed material composition.

Q7 – What is the frequency of infections with TMJ Concepts devices?
A7 – Infection is the most common complication, but the risk is low – 2 to 3%. Infections can develop at the time of surgery, or sometimes even many years later. There is no absolute test for the preoperative diagnosis of periprosthetic joint infection (PJI); thus, clinical practice relies on a combination of supportive tests and criteria. (Mercuri LG. Temporomandibular Joint Replacement Periprosthetic Joint Infections: A Review of Early Diagnostic Testing Options. Int J Oral Maxillofac Surg 43:1236–1242, 2014.)

Q8 – When executing a combined TMJ replacement and maxillary orthognathic surgery case, should the TMJ replacement be performed first or the maxilla?
A8 – TMJ replacement should always be performed first in combined maxillary and TMJ Concepts cases. If the maxilla is performed first, and not positioned in the exact pre-surgically designed position, the custom TMJ Concepts components may not interface properly with the host bone nor articulate appropriately.

Q9 – Are the implants returnable if the patient does not have the surgery?
A9 – TMJ Concepts implants are custom-made and are not returnable. Once shipped, full payment will be expected against the issued purchase order. If implants are in-process when cancellation occurs, partial charges may be incurred.