Management of the Infected Temporomandibular Joint Total Joint Prosthesis

Assessment of clinical parameters and patient satisfaction submitted to rehabilitation with total joint prostheses of temporomandibular joint

“…Some authors refer in their studies that the most common complications are neuropraxis mainly caused by retraction maneuvers and use of electrocautery, and intraoperative bleeding due to injury of maxillary artery branches and plexus pterigoideo 4 in addition to infections, malocclusion, hematoma, metallic component dislocations, prosthesis attachment loss, and even locoregional bone formation are likely to happen [4,15], suggesting this procedure requires some experience of the surgical team; however, when the procedure is performed with well-employed surgical technique, along with adequate postoperative follow-up, clinical success is expected as with our study. In this study postoperative comfort was not directly related to the intraoperative aspect of the TMJ, to the number of prosthesis used, to the masticatory satisfaction level after surgery, to the improvement in social life or to the differences between the pre-and postoperative for any of the measures studied as well as the studies [1, 8,15,17,34].…”

“…However, for patients without previous interventions and normal anatomy, "stock" prosthesis is a good alternative, eliminating costs and elaboration time 22 , according to our study in which most of the patients (25 to 56.8%) had not undergone previous surgery and obtained excellent results with the Biomet stock prosthesis [1, 8,15,17,[23][24][25] .…”

“…There is concern about the contralateral joint stability, periodontal changes and anatomical and functional restrictions in cases of unilateral prosthesis [15], but complications were not observed, to these days, in the patients who underwent this particular procedure (15-34.1%). As conclusion, total TMJs replacement with prostheses have good results with improved function and decreased pain with few complications according with the literature [8] and [16][17][18][19]. And the database will grow as surgeons adhere to their routine, the TMJ reconstruction with use of aloplastic prostheses and the prostheses are prospectively followed for at least 10 years [1].…”

“…Recent studies demonstrate that alloplastic devices have advantages when compared to autografts for the rehabilitation of patients, especially when considering the need of donor sites, morbidity and surgical time, and longer lasting results [1, 4,8,17,21,25].…”

Guidelines of the Infectious Diseases Society of America for the Treatment of Methicillin-Resistant Staphylococcus aureus Infections: As Applied to Oral and Maxillofacial Clinical Practice

“…With the advent of various TMJ prosthesis, a vast number of patients are requiring total joint reconstruction are benefited. Although TMJ total joint prostheses can become infected, as any other prosthetic device in the human system [15]. According to the recommendations [7], for the management of MRSA bone and joint infections (osteomyelitis, septic arthritis and infections involving joint prosthesis) surgical debridement and drainage should be given emphasis and remain the mainstay of the treatment.…”