To date, few reports have combined patient-specific guides with piezoelectric devices for gap arthroplasty in children. This study evaluates the feasibility, accuracy, and early outcomes of this approach, hypothesizing that the combination of narrow-slit surgical guides and piezoelectric osteotomy provides safe and reproducible results in pediatric TMJ ankylosis.

A prospective pilot study was conducted on [n] children (mean age [x] years) with TMJ ankylosis. Virtual surgical planning and CAD/CAM fabrication were used to design patient-specific guides with narrower osteotomy slits (width [x] mm) to allow precise bone removal and improved condylar fit. Preoperative and postoperative CT scans were superimposed to measure the accuracy of gap creation. Functional outcomes included maximal interincisal opening (MIO) at 1, 3, and 6 months, and complications.

Inclusion Criteria:

1. patient with TMJ ankylosis.
2. less than 15 years old at the time of surgery

Exclusion Criteria:

1. Fibrous ankylosis without bony involvement
2. Associated craniofacial syndromes
3. Patients with systemic conditions contraindicating surgery

All data will be de-identified to protect the participant data. patients signed an informed consent for the use of their medical records and data for study.