Kristina’s road to jaw reconstruction started when she was in her early twenties. Her dentist noticed she had a bad overbite and only two of her back teeth were touching when she bit down.
Concerned about the wear and tear this could cause on her teeth and possible future issues, her dentist suggested she visit an orthodontist. During an evaluation, the orthodontist found her jaw condyles were bone-on-bone.
“I had difficulty biting into pizza. I couldn’t eat a sandwich or a bagel,” Kristina recalled.
Because of the complexity of Kristina’s condition, the orthodontist referred her to Penn Medicine’s oral and maxillofacial surgeons who are internationally renowned and true pioneers in temporomandibular joint (TMJ) surgery.
“Kristina had idiopathic condylar resorption, a condition that only affects the TMJ and results in significant joint breakdown,” explained Eric Granquist, DMD, MD, Director of Penn Medicine’s Center for Temporomandibular Joint Disease. “This can often result in a change to the bite along with pain and difficulties eating.”
Dr. Granquist recommended Kristina have TMJ replacement surgery to fix her bite and alleviate her pain.
“As a [physician assistant], I knew there were a lot of risks with surgery on your face. I was worried about nerve damage, eyelid drooping or numbness,” Kristina said.
Second Opinion, Support Help Kristina Weigh Options
To help in her decision-making, Kristina explored her options.
She had imaging studies that confirmed her case was severe. She sought a second opinion and the resident told her it was the worst case he’d ever seen. and she joined a special Facebook group where she communicated with and learned from other people facing similar issues.
“Without my family and the Facebook group, I don’t think I would have gotten through it,” Kristina said. “It’s so uncommon for people to have this. It was nice to have the space to discuss my decision with people who understood.”
A Nickel Allergy Complicates Jaw Reconstruction
Kristina wanted to have children, and it seemed most prudent to have surgery before she started her family.
After nearly a year of weighing her options, Kristina decided to have TMJ replacement surgery and jaw reconstruction with Dr. Granquist.
Because she had a severe nickel allergy, Kristina needed custom-made, full-titanium joints, which require Compassionate Use approval through the FDA. This type of approval is granted only for single use on a case-by-case basis. It is a complex process that includes coordination of approvals through an institutional review board (IRB), the FDA and the manufacturer.
Because of their expertise treating a variety of patients with complex needs, the team at Penn was familiar and able to navigate this process with Kristina.
“Penn worked with me through several denials to get the joints I needed,” Kristina said.
Seeing some of the highest volumes of TMJ joint replacement in the country, Penn Medicine team has significant experience coordinating surgeries for patients with TMJ disease. Dr. Granquist and the team also have access to advanced technologies such as virtual planning, CT imaging in the OR and an experienced interventional radiology team. The wealth of surgical experience translates into a better overall patient experience and improved outcomes.
A Long but Successful Surgery
Dr. Granquist performed Kristina’s surgery on Feb. 3, 2020.
Given the complexities of Kristina’s surgery and the intricacies of properly placing custom devices where millimeters matter, the Penn team used intra-operative CT imaging to ensure the procedure was a success.
Kristina had prepared her body and her mind for her upcoming surgery. She also planned a thoughtful touch for her husband on the day of surgery.
“I did everything I could do to improve my body,” Kristina said. “I took steps to decrease inflammation. I eliminated gluten, sugar and dairy. I took supplements. I tried essential oils for healing and stress even though I never believed in them. I also wrote a card for each hour I was in surgery for my husband,”.
The surgery was a success and today, Kristina can eat normally and is pain-free. She is also living her dream of parenthood and working as a PA.
Why Penn Medicine: More Experience Leads to Better Patient Outcomes
Kristina attributes her excellent outcome to the team at Penn Medicine.
She says the staff was supportive and communication was excellent.
“Dr. Granquist is a great doctor and surgeon,” Kristina said.“Everyone was caring and responsive. It was fantastic from start to finish! I am very thankful for Dr. Granquist and his team!”
Having extensive experience and surgical volumes helps the team at Penn develop new patient protocols, such as the enhanced recovery after surgery program (ERAS). ERAS leads to improved pain control and better patient outcomes.
“Also, having outstanding nursing and anesthesia teams who are familiar with patients undergoing these complex TMJ surgeries helps to ensure the best patient experience,” Dr. Granquist said.
Need a Second Opinion?
Have you been told you need TMJ surgery? You can receive a second opinion from the experts at Penn Medicine’s Center for Temporomandibular Joint Disease.
Through our second opinion program, we offer remote second opinions to patients from the following states: California, Florida, Georgia, Maryland, Michigan, New York, North Carolina, Pennsylvania, South Carolina, Virginia, Wisconsin and Washington, DC.