There is a very specific group of condyle fracture which associated with fractures of the middle cranial fossa, and in some cases the mandibular condyle can invade cranial fossa, requiring a very specific diagnosis and treatment. The aim of this paper is to present a report of case of a fracture of the cranial fossa by impaction of mandibular condyle treated with TMJ custom prothesis. Patient, F.J. 18 years old, victim of a motorcycle accident, attended the Emergency of the Hospital Espanhol in city of Rio de Janeiro – RJ, Brazil, which had lesions of abrasion in the region of the chin, malocclusion and limitation of mouth opening. Imaging was performed, where she was diagnosed that the left condyle had impacted to the middle cranial fossa and a fractured neck of the right condyle. The proposed treatment was the reduction and rigid fixation of the right condyle and total joint reconstruction in left condyle with the use of a total TMJ custom prothesis, using the combined retromandibular and endaural access. During the removal of the condyle of the middle cranial fossa, there was no evolution in brain hemorrhage or cerebral spinal fluid drainage, and the temporal component of the TMJ prosthesis is fully adapted to the region, banning all communication of the cranial fossa with the joint space. We conclude that the use of a TMJ custom prothesis was an excellent choice to correction of this fracture and maintaining the functional activities of the patient.

Conflict of interest: None declared.