Does the Amount of Screw Fixation Utilized for the Condylar Component of the TMJ Concepts Total Temporomandibular Joint Reconstruction Predispose to Hardware Loss or Postoperative Complications?

Ettinger, Kyle S.; Arce, Kevin; Fillmore, W. Jonathan; Ess, James M. Van; Yetzer, Jacob G.; Viozzi, Christopher F.

doi:10.1016/j.joms.2016.03.041

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…Previous TMJ reconstructive studies found that using a certain threshold of the prostheses’ screw holes may hold insight into complications. It was discovered that using fewer than 100% of the available screw holes does not predispose the reconstruction to hardware loss, but that it was beneficial to achieve at least 50% screw fixation or use at least five screws.…”

Section: Discussionmentioning

confidence: 99%

Adverse events involving mandibular hardware: an analysis of the Food and Drug Administration Facility Device Experience data

et al. 2018

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Purpose: To investigate frequencies and characteristics concerning mandibular device complications as reported to the Food and Drug Administration. Study Design: Retrospective database review. Methods: The Manufacturer and User Facility Device Experience (MAUDE) database was queried for reports from 2007 to 2017 using the keywords 'mandible' and 'mandibular'. A total of 3592 reports were gathered. After curating out duplicate reports, reports not applicable to mandibular hardware, and literature articles, 1899 event device reports were subsequently studied for mandibular hardware. A side cohort of 192 TMJ device reports was analysed separately. Reports were reviewed based on both the device cited in the report and the concerns cited in the event text (i.e. an explanation of a plate fracture/failure or of an infection). Additional frequencies involving the company manufacturers and reported patient injury were also analysed. Results: The majority of the 1899 mandibular device reports cited screw failures (20.4%), infection (15.8%), plate fracture (12.9%), or distractor malfunction (7.9%). Of all the records, 60.3% self-categorised themselves as 'injury' events, whereas 36.4% self-classified as 'malfunction' reports. The plate fractures consisted of 79.8% occurring post-operatively and 14.0% intra-operatively. A majority of the implicated screw failures were regular, non-intermaxillary fixation/ mandibulomaxillary fixation screws (75.3%). Depuy Synthes (59.6%) and Stryker (16.6%) were most often implicated in these 1899 mandibular reports. Of the separate 192 TMJ reports, the events indicated mainly jaw pain 32.0%, incorrect fit of the device (11.2%), infection (10.7%), loose screws (9.6%), and dislocation in the patient post-operatively (7.6%), with Biomet involved in the majority of reports (90.8%). Conclusions: The MAUDE reports on mandibular devices correspond with the major adverse events cited in previous literature. The reports delineate areas of improvement for both manufacturers (i.e. postoperative hardware failure and intra-operative equipment failures) verses probable user error (i.e. intra-operative plate and patient injuries).

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Section: Discussionmentioning

confidence: 99%

Adverse events involving mandibular hardware: an analysis of the Food and Drug Administration Facility Device Experience data

et al. 2018

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“…The component of the mandibular fossa is screw-retained to the lateral edge of the glenoid cavity while the mandibular component is screw-retained to the ramus [11]. The screw retaining must provide a maximum stability according to the manufacturer's guidelines [56]. However, the access to the uppermost holes, close to the condyle, may not be possible without resorting to tissue retraction maneuvers, that increases the risk of tissue damage.…”

Section: Standard and Custom-made Tmj Tjr Prosthesesmentioning

confidence: 99%

A Preliminary Analysis of the Wear Pathways of Sliding Contacts on Temporomandibular Joint Total Joint Replacement Prostheses

Pinto-Borges

Carvalho

Henriques

et al. 2021

Metals

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In the last years, several materials and design have been assessed in an attempt to improve the mechanical performance of temporomandibular joint total joint replacement (TMJ TJR) prostheses. However, the wear of the TMJ TJR condyle to the polymer-based fossa component during loading and sliding movements. That promotes the release of debris and risks of toxicity to the surrounding tissues. The purpose of this study was to perform a narrative literature review on the wear of TMJ TJR sliding contacts and potential toxicity of metallic debris to the patients. Previous studies reported a significant deterioration of the sliding contact surfaces of TMJ TJR prostheses. Material loss as a result of wear can cause a TMJ TJR condyle/fossa mismatch and the modification of the contact pressure and chewing loading. As a further consequence of wear, metal particles are released to the surrounding tissues with a high risk of local tissue and systemic toxicity through the bloodstream. The presence of particles induces the stimulation of inflammatory reactions depending on the concentration and size of debris. Thus, CoCr-based condyle release metallic ions and sub-micron particles that can be engulfed by macrophages or internalized by other tissue cells. The wear and material loss of TMJ TJR could be decreased by design optimization and novel materials with low friction and contact pressure. That consequently decrease the amount of metallic ions and particles to the surrounding tissues, preventing peri-prosthetic inflammatory reactions.

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“…O componente da fossa mandibular é fixado ao bordo lateral da cavidade glenóide com 4 parafusos enquanto o componente mandibular é fixado ao ramo com 7 a 9 parafusos bicorticais (L. et al, 2016). De modo a atingir o máximo de estabilidade, recomenda-se que todos os orificios para os parafusos sejam utilizados, como é norma do fabricante (Ettinger et al, 2016). O acesso aos orifícios mais superiores, junto ao côndilo, pode não ser possível, sem recorrer a manobras de retração dos tecidos, o que aumenta o risco de dano das estruturas.…”

Section: Próteses Da Atm Personalizadasunclassified

“…O acesso aos orifícios mais superiores, junto ao côndilo, pode não ser possível, sem recorrer a manobras de retração dos tecidos, o que aumenta o risco de dano das estruturas. Na fixação do componente condilar, usando entre 50 a 100% (pelo menos 5 parafusos) não predispõe à falha ou à perda de material (Ettinger et al, 2016). Uma modificação que hoje em dia é padrão em todos os dispositivos é um orifício introduzido logo abaixo da cabeça condilar e que pode ser colocado de medial para lateral ou anterior para posterior, dependendo da preferência do cirurgião (Farzad, 2017).…”

Section: Próteses Da Atm Personalizadasunclassified

“…De acordo com os dados obtidos, obteve-se uma melhoria nos valores de medida incisal, dor, função e dieta e nenhuma das próteses falhou, o que indica grande durabilidade destes dispositivos Wolford et al, 2015). Existem inúmeros artigos publicados que validam o uso com sucesso das próteses personalizadas com indicação de melhoria significativa da abertura incisal e funçao mandibular e nos niveis de dor, com cerca de 87% dos pacientes relatando melhoria na qualidade de vida (Ettinger et al, 2016;Park et al, 2017;Ramos and Mesnard, 2015;Wolford et al, 2015).…”

Section: Próteses Da Atm Personalizadasunclassified

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Desgaste das próteses da articulação temporomandibular: uma revisão narrativa

Borges¹,

Carvalho

Henriques

et al. 2021

RevSALUS

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Does the Amount of Screw Fixation Utilized for the Condylar Component of the TMJ Concepts Total Temporomandibular Joint Reconstruction Predispose to Hardware Loss or Postoperative Complications?

Cited by 9 publications

References 26 publications

Adverse events involving mandibular hardware: an analysis of the Food and Drug Administration Facility Device Experience data

Adverse events involving mandibular hardware: an analysis of the Food and Drug Administration Facility Device Experience data

A Preliminary Analysis of the Wear Pathways of Sliding Contacts on Temporomandibular Joint Total Joint Replacement Prostheses

Desgaste das próteses da articulação temporomandibular: uma revisão narrativa

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