3D-Printed Implant Brings Relief to Singapore Woman After 30 Years of Jaw Pain

A Long Road of Misdiagnosis and Persistent Pain

SINGAPORE: 71-year-old Madam Kong Choy Foong recently experienced significant relief after decades of persistent jaw pain, thanks to a customized, 3D-printed implant. For nearly 30 years, Madam Kong had suffered from what she described as sudden, sharp jaw pain. “Sometimes the pain came when I was sleeping, waking me up at night,” she recalled, according to The Straits Times. Misdiagnosed and dismissed at times, her condition led to an escalating impact on her quality of life, ultimately affecting her ability to sleep, eat, and speak.

Madam Kong’s symptoms were initially attributed to teeth grinding, leading to the recommendation of a dental splint—a device used to alleviate strain on the jaw. However, the splint provided no relief, and the pain persisted.

A Rare Diagnosis Reveals a Complex Condition

In 2020, a referral to Ng Teng Fong General Hospital brought new attention to Madam Kong’s temporomandibular joint (TMJ), the joint connecting the jaw to the skull. By January 2022, after a series of comprehensive tests at the National University Centre for Oral Health Singapore (NUCOHS), she was diagnosed with pseudo-gout of the TMJ—a rare condition that causes severe pain and swelling in joints, usually larger ones like the knees or hips.

“Having a growth at the jaw joint is not common,” said Associate Professor Asher Lim, the senior consultant in oral and maxillofacial surgery at NUCOHS who treated her. Medical imaging revealed a 2.5 cm growth around Madam Kong’s jaw joint, leading to open joint surgery in September 2022. While the initial surgery successfully removed the growth, it regrew within months, and the pain returned with increasing severity.

Innovative Use of a 3D-Printed Implant

Facing a recurrence of symptoms, Professor Lim and his team explored alternative solutions for Madam Kong. Her age and the severity of her jaw damage made more conventional treatments, such as synthetic joint replacements or bone grafts, less viable. Instead, a personalized, 3D-printed titanium implant was chosen to replace her damaged TMJ, offering a tailored solution for her unique anatomy.

Working with a medical manufacturer in Australia, Professor Lim’s team provided a computed tomography (CT) scan of Madam Kong’s jaw, allowing for the creation of an implant specifically suited to her structure. The implant combined a titanium alloy with ultra-high molecular weight polyethylene, a durable, non-toxic material.

Successful Surgery and Improved Quality of Life

The surgery took place in May 2024, involving the removal of both the growth and a section of bone in the jaw. While there were risks, such as possible facial nerve damage and infection from salivary gland disturbance, Madam Kong’s operation proceeded without complications, according to The Straits Times. She now enjoys normal function, able to speak and eat without pain or restriction.

Notably, Madam Kong felt reassured during her second surgery, due to her confidence in Professor Lim’s skill and care. “I was more assured because it’s the same doctor, so I knew the outcome would be good,” she said, describing her relief after years of suffering.

Hope for Others with Pseudo-Gout of the Jaw

Professor Lim’s success with Madam Kong’s implant has already benefited others. He reported encountering a similar case shortly after Madam Kong’s surgery, suggesting that this innovative approach could provide a new standard of care for similar conditions in Singapore and beyond.

This case is part of The Straits Times’ “Medical Mysteries” series, which highlights rare and unusual medical cases and the innovative treatments that can change lives.