Introduction: Nowadays, the surgical approach of the temporomandibular joint (TMJ) disorder is controversed, the extensive TMJ disease with failure of conservatory treatment are treated by different surgical ways: conservatory arthroplasty (disc ectomy, discopexy), TMJ reconstruction by autogeneous tissues (costal graft), alloplastic joint reconstruction. In our institution, our surgical approach of extensive TMJ disease use a combination of: condyloplasty, joint recovery (conchal cartilage graft), superficial temporal flap, coronoidal apophysis section.

Study: On last 5 years, 9 patients with 13 TMJ advanced diseases (after more than one year conservatory treatment) have been operated with this technic. The average follow up is 3 years. These patients presented important decrease of jaw opening (from 0 to 20 mm) and major TMJ pain (pain score 5–8).

Results: Increasing jaw opening (from 28 to 50 mm) and disappearing TMJ pain in almost all the patients.

Conclusion: This technic of TMJ reconstruction using autogeneous tissues (in extensive TMJ disease) results in significant restoration of TMJ function (jaw opening), pain reduction and increasing quality of life.