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Alloplastic total temporomandibular joint replacement in skeletally immature patients: a pilot survey
Institution:1. Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA;2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA;3. TMJ Concepts, Ventura, CA, USA;4. Department of Oral and Maxillofacial Surgery, The University of Oklahoma, Oklahoma City, OK, USA;1. 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. Department of Radiology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;1. Resident, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & 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 & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;3. Professor, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;4. Attending surgeon, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;6. Resident, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China;5. Resident, Department of Oral Surgery, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. National Clinical Research Center of Stomatology, Shanghai, China;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;1. Oral and Maxillofacial Surgery Resident, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX;2. Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; and Clinical Consultant, TMJ Concepts, Ventura, CA;3. Associate Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
Abstract: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 total of 24 custom/patient-specific TMJ Concepts devices were implanted into 14 patients (eight male and six female). Their mean age was 14 years (range 7–17 years). Nine (64.3%) had bilateral devices and five (35.7%) had unilateral devices. The most prevalent diagnosis was idiopathic condylar resorption (33.3%), followed by ankylosis (16.7%). Concurrent orthognathic surgery was performed in four patients (28.6%). The TMJR was completed as a one-stage procedure in 11 patients (78.6%) and in two stages in three patients (21.4%). All surgeons reported improvements in maximum incisal opening with good function. The respondents reported no asymmetric mandibular growth or retrognathia after either bilateral or unilateral TMJR implantation. This pilot study indicates that the use of TMJR in the growing patient may be a useful modality in select cases. The encouraging results of experienced surgeons demonstrate and support the need for further studies on the utilization of TMJR in this patient population.
Keywords:temporomandibular  joint  TMJ  replacement  alloplastic  TMJR  prosthesis  growing  pediatric  total
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