fig18

Figure 18. Pruzansky-Kaban Type IIb cases. A Temporal approach provides access to both the calvarial bone donor region and to the joint. Additional submandibular access is not required to osteosynthetize the costochondral graft to the ascending ramus. (a) The calvarial donor defect is reconstructed using calcium phosphate paste (Hydroset, Stryker); (b) the joint can be exposed and reconstructed in "open sky" mode; (c) two osteosynthesis screws have fixed the new condyle to the ascending ramus (arrows)