A prospective,single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis |
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| Affiliation: | 1. Maxillofacial Unit, Royal Shrewsbury Hospital, Shrewsbury SY3 8XQ, UK;2. Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 7LN, UK;3. Regional Maxillofacial Unit, University Hospital Aintree, Liverpool L9 7LN, UK;4. Maxillofacial Unit, Queens Medical Centre, Nottingham NG7 2UH, UK;5. Maxillofacial Unit, Queen Elizabeth Hospital, Birmingham B15 2TH, UK;6. Maxillofacial Unit, Bradford Teaching Hospitals, Bradford BD9 6RJ, UK;1. Registrar, Oral and Maxillofacial Surgery Unit, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;2. Consultant Surgeon, John Hunter Hospital, and Private Practice, Newcastle, New South Wales, Australia;3. Professor, Department of Surgery, James Cook University, and Former Consultant Maxillofacial Surgeon, Townsville Hospital, Queensland, Australia;4. Consultant Surgeon, Private Practice, Melbourne, Victoria, Australia;1. Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas; Private Practice, Baylor University Medical Center, Dallas, TX;2. Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; Clinical Consultant, TMJ Concepts, Ventura, CA;3. Professor, Department of Biomedical Sciences, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX;4. Former Fellow, Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX; Clinical Assistant Professor, Department of Orthodontics, St Louis University, Center for Advanced Dental Education, St Louis, MO;6. Former Fellow, Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX; Private Practice, Louisville, KY;1. Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain;2. Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Seville, Spain |
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| Abstract: | This study describes the clinical variables in 61 patients following total alloplastic temporomandibular joint reconstruction (TJR) in which the Biomet Microfixation Patient-Patient-Matched TMJ Implant was used. All patients were classified using the Wilkes classification. The visual analogue scale score for jaw pain intensity, the maximum inter-incisal opening (MIO), and the frequency of adverse events were recorded during follow-up; the mean follow-up was 14.2 ± 8.6 months. Significant improvements were found in the MIO (P < 0.0005), except at the 3-year follow-up. Additionally, a significant reduction in pain was observed both short and long term (P < 0.0005). The incidence of adverse events was low (seven of the 81 alloplastic joints); two joints needed revision. TJR appears to be a relevant treatment option in patients with a broad range of temporomandibular joint disorders in whom none of the joint components are salvageable because of significant disease. Our patients gained an almost normal range of mouth opening and experienced a significant reduction in pain. Our results are promising, however TJR is associated with some side effects. TJR should be considered when less invasive procedures fail and a comprehensive presurgical work-up has been performed. Ongoing prospective studies are needed to consolidate the possible significant treatment outcomes. |
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| Keywords: | total joint replacement temporomandibular disorders TMJ reconstruction alloplastic reconstruction |
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