Can't have BIMAX due to previous surgery on condoyle

[Fowler]

Hello

Wondering if anyone has been told they aren't a good candidate for bimax? I had to have a bony spur removed from my tmj in 2005 which regrew and was removed again in 2012 by the NHS (I'm in England).
Went to discuss bimax with a private surgeon and I have been told there wouldn't be enough support to carry out the operation due to the NHS surgeon chopping out the condoyle.
I am unsure if I can have a prostetic tmj implant followed by bimax? I believe the implant holds the jaw in place stopping it from being moved from side to side.

[april]

You can absolutely have tmj replacements at the same time as bimax.
Joint replacements should be considered 'last resort' though. The surgery and recovery is apparently brutal, and it's something you must to do multiple times throughout your life (How old are you?). You will lose all lateral movement, as well as backward and forward. When you chew it will only be an up and down movement.

They're prob concerned the spur may grow back, so you results may not be stable. Or it could go the other way and degenerate. Have you got arthritis in your tmj? Did they actually remove your condyle?! (Xrays?) If so your bite must be completely out of whack, and very open on one side?

You would have to have the tmj replacement and bimax during the same surgery. If they just put it in the replacement on it's own the bite may not fit. Most people who need replacements have bimax at the same time.

[Fowler]

Thanks for your reply.
I'm 34. The joint replacement would hopefully be a 3D printed titanium one so would hopefully be permanent for life.
I do have the beginning of arthritis in my right tmj where the left one had the condoylectomy putting pressure on the right side.
I believe a condoylectomy was performed as the spur was removed in 2005 and then grew back and was removed again in 2012.
My bite isn't ridiculously bad but I have an occlusal cant which has got got progressively worse since 2012 since I had the condoylectomy.
I will have to have something done as there just isn't the support around the left Tmj which has put the pressure on the right side. Appreciate I'll lose movement in my jaw but without something done, the arthritis is only going to get worse. 
I saw Piet Haers and he advised 2 options. 1 being a prosthetic replacement without bimax and 2 having bimax done at the same time the jaw joint replacement is fitted. Appreciate your comments about the replacement maybe not fitting without bimax done.
It's going to be a long wait now as I am back on the NHS waiting list and expect to be fobbed off if I am honest even with Piet advising his recommendation to them. Going to fight my corner as I am experiencing a fair bit of pain some days and all this should have been sorted years ago.

I do have some x rays but my scanner isn't working. I'll have to see if I can scan them in from work. Thanks again for your input april. 

[april]

Thanks for your reply.
I'm 34. The joint replacement would hopefully be a 3D printed titanium one so would hopefully be permanent for life.

There's no long-term data on them: the ones they use today haven't been around long enough for anyone to know if they'll last more than 20+ years.
10-15 years is considered a good run.
Will it be Biomet or TMJ Concepts?

I will have to have something done as there just isn't the support around the left Tmj which has put the pressure on the right side. Appreciate I'll lose movement in my jaw but without something done, the arthritis is only going to get worse. 

Does it cause you pain? How is your function?
I'll PM you some links to find more info/patients.

[Fowler]

There's no long-term data on them: the ones they use today haven't been around long enough for anyone to know if they'll last more than 20+ years.
10-15 years is considered a good run.
Will it be Biomet or TMJ Concepts?

I'd take that to be honest and then see where we are in 10, 15 years or so.

Does it cause you pain? How is your function?
I'll PM you some links to find more info/patients.

It is causing me pain.  This has been mild for a few years but is getting worse.  Function is getting worse too as have found it harder speaking.  I sometimes find my talking as if I have a lisp and sometimes let out a whistle.  Don't know if you have heard the gopher from Winnie the Pooh but sometimes sound like that lol.  Jokes aside, it is quite painful and I can feel the lack of support on the left side putting pressure on the right.  Be great if you cab PM me, thanks for your help.     

[Fowler]

Also, I'm unsure if it will be be Biomet or TMJ Concepts.  I am awaiting my appointment on the NHS but Piet Haers has advised I need a replacement fitted and I going from there.  My scanner is no working and have attached my x-ray.  Hope it is visible.  Even to the untrained eye, you can see the left side doesn't seem to have as much bone visible as the right side. 

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