The preoperative patient assessment remains paramount in being able to risk stratify patients contemplating TMJ TJR . There are a number of endogenous (patient- related) and exogenous (process-/procedure-related) variables that affect a patient’s risk for development of a surgically related infection. Some endogenous factors cannot be changed, such as age, gender, and genetic factors . However, a number of exogenous factors may exist that can be improved to decrease the potential for the development of an infection . Preoperative variables can be addressed to reduce the risk of complications.
TMJ TJR surgical candidates, such as those with ankylosis or other pathologic conditions that prevent them from maintaining a proper diet over an extended period of time, may require nutritional and hematologic evaluation and intervention before TMJ TJR. Possible interventions include family support discussions, diet counseling, vitamin and iron supplements, transfusion, and social service referrals. Depending on the surgical urgency, delay of surgery until the patient’s nutritional and hematologic status improves may be indicated .