Reconstruction of the temporomandibular joint autogenous compared with alloplastic.

Specialist Registrar, Department of Oral and Maxillofacial Surgery, Cheltenham General Hospital, Sandford Road, Cheltenham, GL53 7AN, UK.
British Journal of Oral and Maxillofacial Surgery (Impact Factor: 2.72). 09/2002; 40(4):296-9. DOI: 10.1016/S0266-4356(02)00139-0
Source: PubMed

ABSTRACT The aims of and indications for temporomandibular joint (TMJ) reconstruction are well-established but the method of reconstruction is controversial. We describe a retrospective, two-centre audit of 49 patients treated with costochondral grafting and 50 patients treated with alloplastic joints. The characteristics of the patients were similar in both centres and the minimum follow-up period was 2 years. For each patient a number of variables were recorded including both subjective scores (pain and interference with eating) and objective data (interincisal distance). Patients in both groups showed an improvement in symptoms but more patients required reoperation in the autogenous group.

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    ABSTRACT: Purpose The aim of this study was to assess pain, function, diet and quality of life in subjects undergoing alloplastic temporomandibular joint reconstruction. Methods Seventy-two subjects were sent a questionnaire at an average of 4 years after receiving either unilateral or bilateral total joint replacement with custom TMJ Concepts or stock Biomet total joint replacement. Changes in pain, function, diet and quality of life were assessed. Results Fifty-two subjects returned questionnaires. Pain, function, diet and QOL were all significantly improved at a mean follow up of 46.3 months. Complications reported included altered facial sensation and facial weakness. No implant failures were reported. Conclusion The placement of alloplastic temporomandibular joint total joint replacements may provide benefits for patients in the areas of pain, function, diet and quality of life. Further research is required in the area.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 01/2014; · 1.58 Impact Factor
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    ABSTRACT: The purpose of this paper is to present the postoperative results obtained after full temporomandibular joint (TMJ) reconstruction employing the Biomet/Lorenz Microfixation TMJ replacement system (Jacksonville, FL, USA) in 300 patients (201 unilateral, 99 bilateral). Objective data (maximum inter-incisal opening; MIO) and subjective data (function and speech, diet, and pain) were collected preoperatively and at postoperative evaluations performed over a 10-year period (mean 3.5, standard deviation 2.1 years). The MIO measures were obtained using a calliper rule. Subjective data were evaluated using a visual analogue scale with scores ranging from 0 to 5 for each variable. The results were analyzed with the paired t-test (two-sided, α=5%). Each patient showed significant improvements for all of the variables at evaluation on postoperative day 7. The results for MIO, function and speech, and diet, showed improvements at each postoperative evaluation over a maximum of 3 years, with stabilization of the results from the fourth year. Complaints of pain decreased considerably up to the 1-month postoperative evaluation, and no patient reported severe pain at 6 months after surgery. The results presented show that the reconstruction of the TMJ through the installation of the Biomet/Lorenz system prosthesis is a safe and effective option for proper reestablishment of the joint and stomatognathic system function; significant long-term improvements in mandibular range of motion are promoted and pain levels decrease.
    International Journal of Oral and Maxillofacial Surgery 06/2013; · 1.52 Impact Factor
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    ABSTRACT: Total replacement of the temporomandibular joint (TMJ) is an effective treatment for intractable pain and impaired function that is a consequence of end-stage joint disease. Prospective assessment of 138 joint replacements identified an 8% risk of intraoperative dislocation of the joint, which was associated primarily with coronoidectomy (30%) and inflammatory arthropathy (24%). Management included the use of intermaxillary elastic traction and treatment of masticatory dystonia when present. Of the 11 patients who had light elastic traction for one week, only one required further treatment for dislocation. Patients with no intraoperative dislocation did not require elastics, and joints remained stable postoperatively.
    British Journal of Oral and Maxillofacial Surgery 11/2013; · 2.72 Impact Factor

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