Louis G MercuriRush University Medical Center | Rush · Department of Orthopaedic Surgery
Louis G Mercuri
DDS, MS, FDSRCS (Eng) (Honorary)
About
197
Publications
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Introduction
SEM and EDSD analysis of cast, wrought and 3D printed TMJR devices
Additional affiliations
Education
June 1970 - June 1975
September 1966 - June 1970
September 1962 - June 1966
Publications
Publications (197)
The temporomandibular joint (TMJ) is a complex synovial joint shrouded in mystery, as the etiology of many TMJ disorders are unsolved. Idiopathic/progressive condylar resorption (ICR/PCR) is one such TMJ disorder characterized by a gradually deteriorating mandibular condylar mass, resulting in severe mandibular retrognathia, which often accompanied...
Evidence based indications for the use of alloplastic TMJ replacement in the management of end-stage TMJ disorders in maxillofacial surgery
Background:
Temporomandibular joint total joint replacement (TMJTJR) offers patients the opportunity for improved function and reduced pain. TMJTJR also has the potential to affect a patient's emotions in a positive or negative manner.
Purpose:
The purpose of this study was to evaluate changes in emotional state for subjects undergoing TMJTJR....
Background‘Temporomandibular joint disorders (TMDs)’ denote an umbrella term that includes arthritic, musculoskeletal and neuromuscular conditions involving the temporomandibular joint, the masticatory muscles, and the associated tissues. Occlusal devices are one of the common treatment modalities utilized in the conservative management of TMDs. Th...
The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader must be an “out of the box thinker” which requires openness to new ways of seeing the world and...
Hemifacial microsomia (HFM) patients may benefit from extended temporomandibular joint replacements (eTMJR) to improve function and quality of life. A cross-sectional survey was sent to surgeons who place alloplastic temporomandibular joints regarding their experience with and complications encountered when placing eTMJR in patients with HFM. Fifty...
Chronic pain is a possible long-term complication after alloplastic temporomandibular joint reconstruction (TMJR). This study was developed to evaluate various subjective and objective measurements to determine the presence and degree of TMJ pain in patients treated with TMJR regardless of the indication for the operation. A prospective, single-cen...
Temporomandibular joint disorders (TMDs) are conditions that affect the muscles of mastication and joints that connect the mandible to the base of the skull. Although TMJ disorders are associated with symptoms, the causes are not well proven. Chemokines play an important role in the pathogenesis of TMJ disease by promoting chemotaxis inflammatory c...
This is a Letter to the Editor that describes some of the biomechanical concerns with the statements made in This is a LTE that raises some biomechanical statements made in Genovesi W, Comenale IC, Genovesi Filho W, Veloso Fernandes M. Biomechanical comparative analysis of temporomandibular joint, glenoid fossa and head of the condyle of convention...
Purpose
Heterotopic ossification (HO) formed over the major components and fixation screw heads of an alloplastic temporomandibular joint replacement (TMJR) prosthesis can result in decreased quality of life, limited function, prosthesis failure, and hinder prosthesis revision, replacement, or removal. This study simulated HO removal from the major...
There are three accepted management modalities available to reconstructive temporomandibular joint (TMJ) surgeons for total temporomandibular joint reconstruction including autogenous bone grafting, alloplastic replacement, and transport distraction osteogenesis techniques. Bioengineered TMJ devices are currently being investigated and may provide...
Medical device embodiment involves the following elements: materials, design, and manufacturing. Failure of any one of these elements can result in failure of the device, despite the others being satisfactory. The abundance of clinical and basic science literature published since 1986, demonstrates the safety and efficacy of alloplastic temporomand...
Background/purpose
The temporomandibular joint (TMJ) is a bi-arthrodial joint that is composed of the temporal bone glenoid fossa and the condylar head of the mandible both having fibrocartilaginous articular surfaces. Functional overloading of the TMJ is the main cause of TMJ osteoarthritis (TMJ OA) disease. The aim of this study was to establish...
The aims of this paper were to validate a modification of an extended total temporomandibular joint replacement (eTMJR) classification system and develop a classification schematic for ease of reference. High volume TMJ surgeons were asked to score 20 separate eTMJR devices using the updated classification system and inter-rater variability was cal...
Purpose
Medical malpractice claims contribute to the practice of defensive medicine which exposes patients to unnecessary tests and limits access to care. The purpose of this study is to characterize medical malpractice claims involving temporomandibular joint (TMJ) operations by oral and maxillofacial surgeons (OMS) in the United States.
Material...
Purpose
Metallic temporomandibular joint replacement (TMJR) systems vary depending on design, material composition, and manufacturing methods such as casting, forging and additive manufacturing. Therefore, the purpose of this study was to measure the association between manufacturing process of TMJR in terms of microstructure and electrochemical pr...
Citation: Neff, A.; McLeod, N.M.H.; Spijkervet, F.; Riechmann, M.; Vieth, U.; Kolk, A.; Sidebottom, A.J.; Bonte, B.; Speculand, B.; Saridin, C.; et al. The ESTMJS (European Society of Temporomandibular Joint Surgeons) Consensus and Evidence-Based Recommendations on Management of Condylar Dislocation. J. Clin. Med. 2021, 10, 5068. Abstract: Although...
Purpose
This study provides information on the implant alloy microstructure of CoCrMo and Ti6Al4V components of present and former FDA approved TMJR devices to elucidate their material and/or structural reliability.
Materials/Methods
Implant alloy microstructure of TMJR devices was characterized. Samples were analyzed by standard metallographic te...
The nonsurgical and surgical management of painful temporomandibular joint (TMJ) disorders has evolved over the centuries. Unfortunately, etiologic sophisms and often unproven mechanistic treatment philosophies still survive. Reviewing the history of the management of TMJ disorders not only addresses the complexity of the problem, but also demonstr...
Purpose
The amount of maximum voluntary clenching (MVC) force may influence functional loading at the polyethylene / metal bearing surfaces in alloplastic total temporomandibular joint replacement (TMJR). The aim of this study was to measure ipsilateral MVC and estimate the risk for revision due to overloading of the TMJR.
Methods
A prospective co...
Purpose
Mechanical overloading is a key initiating condition for temporomandibular joint (TMJ) osteoarthritis (OA). The integrin-focal adhesion kinase (FAK) signaling axis is implicated in the mechanobiological response of cells through phosphorylation at Tyr397 (pFAK) but poorly defined in TMJ health and disease. We hypothesize that mechanical ove...
Purpose
Unilateral alloplastic total temporomandibular joint reconstruction (TMJR) might influence the contralateral side joint function. This study’s purpose was to estimate the risk for contralateral TMJR and the jaw function of the contralateral untreated temporomandibular joint (TMJ).
Patients and Methods
A prospective cohort study design was...
Purpose
To survey TMJ surgeons to determine current practice trends and perceptions regarding the role of discectomy for treatment of temporomandibular joint (TMJ) internal derangements.
Methods
An anonymous 5-part web-based survey was sent to TMJ surgeons. The survey was created and distributed, and the data were collected with the University of...
Presently, there are two options for the replacement of the temporomandibular joint for end-stage pathology associated with OSA – autogenous bone grafting or alloplastic joint replacement. This chapter presents the evidence-based advantages and disadvantages for each option to assist both the surgeons and their patients as they make the choice. Bas...
The aim of this paper was to validate a previously described classification system for extended total joint replacements (eTJRs) of the temporomandibular joint (TMJ). We engaged an expert panel to review 60 TMJ eTJR devices and classify them using the system, examining their responses for inter-rater agreement and concordance with the correct respo...
Purpose
Total alloplastic temporomandibular joint replacement (TMJR) requires the detachment of the masseter muscle (MM) at its insertion to the lateral ramus and often the resection of the coronoid process (insertion of the temporalis muscle). There is little literature on how a detachment affects the muscles. The present study evaluates the long-...
Custom alloplastic temporomandibular joint (TMJ) reconstruction has been well established for the management of end-stage TMJ disease. However, its use in congenital TMJ deformities is limited. Here, the authors present initial outcomes of skeletally mature patients who underwent custom alloplastic TMJ reconstruction and simultaneous orthognathic s...
The outbreak of coronavirus disease 2019 (COVID-19) is rapidly changing our habits. To date, April 12, 2020, the virus has reached 209 nations, affecting 1.8 million people and causing more than 110,000 deaths. Maxillofacial surgery represents an example of a specialty that has had to adapt to this outbreak, because of the subspecialties of oncolog...
Purpose
The purpose of this study was to report temporomandibular joint alloplastic reconstruction (TMJR) revision and/or replacement rates and its associated complication outcome data gathered from experienced TMJ surgeons, and to review the recent relevant literature.
Materials and Methods
A 21-question anonymous on-line survey was sent to all C...
The aim of this study was to survey an international group of temporomandibular joint surgeons regarding their outcomes with alloplastic total joint replacement in skeletally immature patients and to review the literature linked to autogenous reconstruction and alloplastic replacement of the temporomandibular joint (TMJR) in this population. A tota...
Purpose:
Although concerns regarding implant-related metal hypersensitivity exist, no guidelines have been accepted for screening or treatment of patients with metal sensitivity before temporomandibular joint replacement (TMJR). The present study aimed to determine the trends in TMJR metal sensitivity screening and the effect of positive test resu...
Idiopathic condylar resorption (ICR), alternatively called progressive condylar resorption, is an uncommon aggressive form of degenerative disease of the temporomandibular joint seen mostly in adolescent and young women. ICR occurring before the completion of growth results in a shorter mandibular condyloid process, ramus and body, compensatory gro...
Purpose:
Patients with end-stage temporomandibular joint (TMJ) pathology require TMJ reconstruction, which can be accomplished with autogenous tissue or alloplastic materials. This survey study evaluates experienced TMJ surgeons' preferences for autogenous costochondral grafts (CCGs) and/or alloplastic prostheses for TMJ reconstruction.
Materials...
Total temporomandibular joint (TMJ) replacement has been documented as a viable option for the management of end-stage TMJ disease, but data on long-term outcomes have been reported for only two established systems: TMJ Concepts, and Zimmer Biomet. Other devices are now emerging globally, but reports of preclinical laboratory and clinical outcomes...
The 6th temporomandibular joint (TMJ) Bioengineering Conference (TMJBC) was held June 14-15, 2018, in Redondo Beach, California, 12 years after the first TMJBC. Speakers gave 30 presentations, and came from the United States, Europe, Asia, and Australia. The goal of the conference has remained to foster a continuing forum for bioengineers, scientis...
The goal of this paper is to review the advantages and disadvantages of the various treatment options of temporomandibular joint (TMJ) total joint replacement (TJR). TMJ articles published within the last 20 years were reviewed to collect the information on non-invasive and invasive temporomandibular disorders (TMD) treatment methods. Recent techno...
Purpose
There appears to be little consensus on how to evaluate and manage patients reporting a possible allergic reaction to joint replacement devices containing metal. This article presents an analysis of the current orthopedic literature in this regard as it relates to diagnosis, testing, and management. Based on that evidence, a management algo...
Prosthetic joint infections are not only distressing complications for patients and surgeons, but also have an enormous financial impact on healthcare systems. The reported incidence of prosthetic joint infection is likely underestimated due to difficulties in their diagnosis. This unfortunate complication has challenged joint replacement surgeons...
Presently, there are 2 options for the replacement of the temporomandibular joint for end-stage pathology: autogenous bone grafting or alloplastic joint replacement. This article presents evidence-based advantages and disadvantages for each of these management options to assist both surgeons and their patients in making that choice.
Purpose:
Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology, and management options are controversial. Furthermore, it is difficult for 1 provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of this study was to survey...
Prosthetic total temporomandibular joint (TMJ) replacement (TJR) is well established in the United Kingdom, with clear guidelines for indications and nationally published outcomes. CAD/CAM technology has made it possible to push the boundaries of custom-made TJR to include extended versions (eTJR), which may replace segmental mandibular defects or...
Purpose
The aim of this pilot study was to assay metal concentration in the serum of the patients who had undergone dental implants, orthognathic surgery utilizing rigid metal fixation plates and screws, and total temporomandibular joint replacement (TMJ TJR).
Materials and Methods
Thirty patients were identified and included in this pilot study....
The aim of this study was to perform a literature review on the use of finite element modeling (FEM) for the evaluation of the biomechanical behavior of temporomandibular joint replacement (TMJR) devices. An electronic search of online medical and scientific literature database was conducted using selected search terms. The search identified 307 st...
Arthritis is the most common inflammatory joint disease in children and adults. It has multifactorial etiology resulting in joint degeneration and loss of function. Using a management classification scheme based on clinical signs, symptoms, and imaging, this chapter will present an evidence-based discussion for the management of arthritic condition...
Although the risk factors and diagnosis of heterotopic ossification (HO) are discussed in the orthopedics literature, the etiology of HO, as well as its prevention and management, remain theoretical. Furthermore, there is a lack of information in the literature regarding HO in temporomandibular joint replacement (TMJR). This article provides a qual...
Purpose: The purpose of this preliminary study was to evaluate intraarticular soft tissues of the temporomandibular joint (TMJ) using intraoperative arthroscopy during open reduction and internal fixation (ORIF) of condylar head fractures (CHF). Materials and methods: 26 patients (29 joints) were diagnosed in period of 5 years (2011–2015) with CHF,...
Purpose:
The purpose of this study was to evaluate the level of confidence that senior-level oral and maxillofacial surgery (OMS) residents have in the management of temporomandibular joint (TMJ) disorders, determine their exposure to various invasive TMJ procedures during training, and assess their confidence in performing those procedures on com...
Ever since orthopedic total joint replacement (TJR) was introduced by Sir John Charnley [1], orthopedic joint replacement has gained popularity given the considerable improvement in biocompatibility, functionality, and durability of these devices [2, 3]. Many of these alloplastic joints can function properly for decades [4–6]. However, one of the p...
Purpose:
The purpose of this study was to determine whether failed alloplastic temporomandibular joint replacement (TMJR) devices can elicit the aseptic lymphocyte-dominated vasculitis-associated lesion (ALVAL) reaction seen in some patients with metal-on-metal hip arthroplasties.
Materials and methods:
This study involved analysis of paraffin-e...
Purpose:
This article discusses why the management of temporomandibular joint disorder (TMD) cases leads to some oral and maxillofacial surgeons to actively avoid attracting such patients to their practices, offers some evidence-based explanations, and provides recommendations for resolution that will benefit not only the specialty but more import...
The purpose of this study was to assess the number of alloplastic total temporomandibular joint replacement (TMJ TJR) devices implanted and the complications encountered by members of the American Society of Temporomandibular Joint Surgeons (ASTMJS). A questionnaire was developed using REDCap (Chicago, IL) and an on-line link was e-mailed four time...
Purpose:
The purpose of this study is to provide a statistical projection of the number of alloplastic temporomandibular joint (TMJ) total joint replacements (TJRs) that will be performed in the United States through the year 2030.
Materials and methods:
The program directors of all 101 Commission on Dental Accreditation-accredited oral and maxi...
Statement of significance:
An attempt is made in this study, to examine the retrieved TMJ implants and conduct surface and electrochemical analysis; further a translation research approach is employed to compare the observations from the total hip replacement (THR) retrievals. A total cohort of 31 TMJ TJR devices were studied of which 28 were fail...
It is unlikely that an alloplastic joint with an infinite life span can be developed. All alloplastic joint prostheses will develop wear under functional loading. This wear can be decreased, thus prolonging the life of these devices by using the appropriate materials especially at the articulating interfaces, proper implant design and articulating...
As with any surgical procedure, complications can and will develop, requiring further management. Adverse outcomes may be related to, or affected by the patient’s medical and/or surgical history, the surgeon’s diagnosis and experience, and the patient’s compliance with pre- and postoperative instructions.
End-stage temporomandibular joint (TMJ) pathology resulting in anatomical architectural form distortion and physiological dysfunction dictates the need for total joint replacement (TJR). The complex nature of the TMJ’s functional relationship with the local anatomy and masticatory muscles and the technical requirements of implanting a replacement m...
Revisiting the past is an important first step in understanding the use of alloplastic materials in temporomandibular joint (TMJ) reconstruction. The literature cited is intended to demonstrate first, how in the past many surgeons recognized the need for alloplastic TMJ reconstruction devices for the management of particularly difficult clinical si...
Purpose: Musculoskeletal tissue engineering has advanced to the stage where it has the capability to engineer temporomandibular joint (TMJ) anatomic components. Unfortunately, there is a paucity of literature identifying specific indications for the use of TMJ tissue engineering solutions. The objective of this study was to establish an initial set...
Purpose: To assess the current level of experience and training that oral and maxillofacial surgery (OMS) residents receive in alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) at OMS training programs in the United States. Materials and Methods: A questionnaire was developed using REDCap (Chicago, IL), and an on-line link was...
Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Trauma is the most common cause of T...
This is the first text that deals specifically with TMJ TJR. Each chapter is authored by either a basic science researcher or clinician known for their interest and expertise in this field. The text provides the reader with state-of-the-art analysis of all aspects of total temporomandibular joint replacement (TMJ TJR), starting with cutting-edge ev...
Purpose: Synovial plicae and their relation to pain and disability have been reported in the orthopedic literature in association with the knee and other extremity joints. However, the occurrence of synovial plicae in the temporomandibular joint (TMJ) have rarely been reported. This report describes the surgical appearance, distribution, and histol...
Synovial plicae and their relation to pain and disability have been reported in the orthopedic literature in association with the knee and other extremity joints. However, the occurrence of synovial plicae in the temporomandibular joint (TMJ) have rarely been reported. This report describes the surgical appearance, distribution, and histologic find...
To evaluate subjective and objective outcomes of patients receiving Te