Elena Rappa, Bruno Santos, Marie-Pauline Maurin

Background

Temporomandibular joint (TMJ) dysplasia is an uncommon condition in dogs and cats characterized by excessive joint laxity, leading to pain, subluxation, and episodic open-mouth locking. The disorder results from abnormal interaction between the coronoid process and the zygomatic arch, and its severity varies widely . Computed tomography (CT) is considered the diagnostic gold standard, with two-position CT (open- and closed-mouth) providing improved evaluation for surgical planning. Previous treatment options include conservative management for mild cases or surgical intervention (e.g., zygomatic arch excision, coronoidectomy) for clinically significant dysfunction. This report aimed to describe the use of sequential two-position CT imaging and a radial saw blade for partial mandibular coronoidectomy in a dog with progressive TMJ dysplasia.

Methods

A one-year-old intact male Basset Hound with worsening TMJ dysplasia underwent clinical evaluation, sedation-assisted oral examination, and CT imaging of the head in both open and closed positions. Imaging revealed bilateral TMJ incongruity, progressive remodelling of the left mandibular condyle, and impingement between the left coronoid process and zygomatic arch during mouth opening, consistent with the patient’s pain and locking episodes . Surgical treatment consisted of a ventrolateral approach to the zygomatic arch and a partial coronoidectomy performed with an 18-mm radial TPLO saw blade, selected based on preoperative CT measurements. Intraoperative manipulation confirmed resolution of impingement. Postoperative CT was performed to verify adequate coronoid height reduction. Standard postoperative analgesia, hospitalization, and dietary modification were administered.

Results

Coronoidectomy successfully eliminated bone contact between the coronoid process and zygomatic arch, with postoperative CT confirming adequate removal of the remodelled coronoid tip. The dog resumed eating soft food just hours after surgery without signs of discomfort or locking, was discharged the following day, and showed no pain or jaw-locking episodes at the 2-week recheck. At 1-year follow-up, the referring veterinarian reported complete resolution of clinical signs, including absence of pain during eating or playing, and no recurrence of open-mouth locking .

Limitations

This report describes a single clinical case, limiting generalizability. The paper does not report long-term imaging beyond the immediate postoperative CT, nor does it compare outcomes with alternative surgical modalities such as piezoelectric osteotomy. The case also lacks objective postoperative functional metrics, relying primarily on clinical observations and owner/veterinarian reports for long-term outcomes .

Conclusions

Two-position CT imaging was essential for diagnosis, surgical planning, and postoperative assessment of TMJ dysplasia in this dog. Use of a radial TPLO saw blade enabled efficient, controlled coronoidectomy without requiring zygomatic arch excision, resulting in rapid recovery and durable functional improvement. The authors suggest that this imaging-supported, minimally invasive coronoidectomy approach may reduce morbidity and improve precision in similar TMJ dysplasia cases.

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