Reconstruction of the temporomandibular joint: a comparison between prefabricated and customized alloplastic prosthetic total joint systems |
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| Affiliation: | 1. Department of Maxillofacial and Facial Plastic Surgery, Central Medical Center Bremen, Germany;2. Institute of Anatomy, University of Leipzig, Germany;3. Department of Orthodontics, University Medical Center Goettingen, Germany;1. Associate Clinical Professor, Department of Medicine and Dentistry, Oral and Maxillofacial Surgery, University of Alberta, Edmonton, AB, Canada;2. Endoscopic Maxillofacial Surgery Fellow, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA;3. Assistant Professor, Department of Oral and Maxillofacial Surgery, Thomas Jefferson University Hospital, Philadelphia, PA;4. Chief, Oral and Maxillofacial Surgery and Dentistry, and Associate Professor, Department of Surgery, Joan & Sanford I. Weill Medical College of Cornell University, New York, NY;5. Director of Endoscopic Maxillofacial Surgery Fellowship, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA;1. Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, FL, USA;2. Division of Oral and Maxillofacial Surgery, Emory University School of Medicine and Children''s Healthcare of Atlanta, Atlanta, GA, USA;3. Division of Facial Pain, Departments of Orthodontics and Neuroscience, University of Florida, Gainesville, FL, USA;1. Dept. of Oral & Maxillofacial Surgery, King''s College Hospital, Denmark Hill, London SE5 9RS, UK;2. Medical Modeling Inc., 17301 West Colfax Avenue, Suite 300 Golden, CO, USA;1. Maxillofacial Department, Royal Brisbane and Women''s Hospital, Brisbane, Queensland, Australia;2. School of Medicine, The University of Queensland, Brisbane, Queensland, Australia;3. Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia;4. Research School of Population Health, The Australian National University, Canberra, Australia;5. College of Medicine, Qatar University, Doha, Qatar;1. Resident Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;2. Professor, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;3. Professor, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, TX |
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| Abstract: | The implantation of an alloplastic total temporomandibular joint (TMJ) prosthesis is an innovative approach for the treatment of end-stage TMJ disorders. Two types of system exist: prefabricated (stock) and customized computer-aided design/computer-aided manufacturing (CAD/CAM) devices. A clinical study was performed to evaluate the effectiveness of these two designs. Twenty-eight patients treated between 2015 and 2017 were included and assigned to two groups: stock prostheses (group 1) and customized CAD/CAM prostheses (group 2). Clinical evaluations were performed at five time-points up to 6 months postoperative. Parameters included maximum interincisal opening, pain, diet, complications, and subjective well-being at the end of follow-up. Differences between pre-surgery and 6-month post-surgery values were highly significant (P < 0.001). No patient required a liquid diet at the end of treatment, and 66% of group 1 patients and 100% of group 2 patients reported improved well-being. Complications were observed in 32% of patients and included temporary paralysis of the facial nerve. In conclusion, clinical outcomes of stock and CAD/CAM prostheses suggested great improvements in mouth opening and reduction of pain as a result of the rehabilitation of TMJ function. Results showed comparable data for the two types of prosthesis design at 6 months postoperative. |
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| Keywords: | alloplastic temporomandibular joint reconstruction temporomandibular joint disorders prosthetic total joint replacement |
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