Temporomandibular joint (TMJ) ankylosis compromises essential functions such as chewing, phonation, and breathing. Surgical treatment aims to restore mandibular mobility and prevent the recurrence of joint fusion. This article describes a technical variation based on Puricelli biconvex arthroplasty, using surgical cement, screw fixation, and 3D-printed cutting guides based on virtual planning, allowing for greater precision in joint reconstruction. In this work, we present the step-by-step process used in the customization of cutting guides, virtual planning, and the production of the interposition material with PMMA associated with fixation with titanium screws as a hybrid method for the treatment of recurrent TMJ ankylosis. This reported technique is demonstrated to be reproducible, low-cost, and effective.

Chronic mandibular osteomyelitis is a challenging condition due to impaired vascularization, necrotic bone, and persistent infection, often requiring combined therapeutic approaches. We report the case of a 49-year-old male presenting with severe mandibular pain, purulent discharge, and radiographic evidence of bone sequestration and pathological fracture following tooth extraction. The patient was treated conservatively with surgical debridement associated with antimicrobial photodynamic therapy using 0.01% methylene blue activated by a 660 nm laser, followed by adjunctive low-level infrared laser therapy for photobiomodulation. Clinical and radiographic follow-up demonstrated resolution of infection, reduction of pain and inflammation, and progressive bone repair without adverse effects. This case highlights that the combination of photodynamic therapy and photobiomodulation may represent a safe and effective adjunctive approach in the management of chronic mandibular osteomyelitis, particularly in patients seeking less invasive alternatives to radical surgical procedures.

Background: Mentoplasty plays a central role in facial harmony, particularly in the correction of chin asymmetries. Advances in digital planning and three-dimensional (3D) printing have enabled the development of patient-specific surgical guides; however, their clinical implementation in public healthcare settings remains limited by workflow complexity and accessibility. Methods: This case series describes three patients who underwent asymmetric mentoplasty using customized, in-house-manufactured 3D-printed cutting and positioning guides. Virtual surgical planning was performed using cone-beam computed tomography (CBCT) data, followed by guide design and fabrication through an in-house digital workflow. Postoperative CBCT was used for descriptive assessment of the correspondence between planned and achieved chin positions using predefined linear reference points. Results: Across the three cases, postoperative CBCT analysis demonstrated encouraging agreement between virtual planning and achieved surgical outcomes. The customized guides facilitated accurate transfer of the planned osteotomy and chin positioning in both symmetric and asymmetric movements. No major intraoperative or postoperative complications were observed. Guide fabrication required low material consumption, enabling rapid in-house production with minimal direct material cost. Conclusions: Within the limitations of a small case series, the proposed in-house digital workflow demonstrated technical feasibility and encouraging agreement between planned and achieved chin positioning in selected asymmetric mentoplasty cases. Further studies with larger samples and standardized accuracy assessment methods are required to confirm these preliminary observations.

Background: Facial asymmetry affecting the mandibular contour may significantly impact facial harmony even in patients with stable occlusion. Although orthognathic surgery remains the standard for skeletal correction, it carries substantial morbidity. In selected cases, contour-focused approaches can achieve meaningful esthetic improvement with reduced surgical burden. Objective: To describe the virtual surgical planning (VSP) workflow and clinical outcome of a unilateral Wing osteotomy for mandibular contour asymmetry. Case presentation: A 24-year-old woman presented with left-sided mandibular contour deficiency and facial asymmetry, despite stable Class I occlusion and preserved function. VSP with contralateral mirroring guided the design of the osteotomy and fabrication of a stereolithographic model and patient-specific cutting guide. Surgery was performed through a tunnelized mandibular approach using a 702 bur and reciprocating saw. Fixation was achieved with pre-bent 2.0 plates adapted to the 3D model, and Bio-Oss Collagen was interposed within the osteotomy gap. Occlusion and mental nerve function were preserved. Results: Postoperatively, the patient demonstrated improved facial symmetry, uneventful healing, preserved long-term neurosensory function, and high esthetic satisfaction. Conclusions: Unilateral Wing osteotomy guided by VSP and patient-specific instrumentation is a predictable, minimally invasive alternative to bimaxillary orthognathic surgery with genioplasty in selected patients presenting contour-focused asymmetry and stable occlusion. This case highlights a rare, underreported application of the technique.