Mandibular Kinematics in Patients With Alloplastic Total Temporomandibular Joint Replacement—A Prospective Study

Linsen, Sabine S.; Reich, Rudolf H.; Teschke, Marcus

doi:10.1016/j.joms.2012.05.026

Cited by 31 publications

(20 citation statements)

References 37 publications

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“…The TMJ is one of the most active joints in the human body, resulting in TMJ diseases being a common problem. The resection and replacement of the diseased TMJ is, however, usually reserved for patients with irreversible end-stage disorders (8-10). TMJR has been one of the major success stories in TMJ surgery in recent years, with clinical success, long-term results, and increased expectation and lifetimes of patients driving the need for improved materials, load-bearing surfaces and designs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study

González-Pérez¹,

Gonzalez-Perez-Somarriba²,

Centeno³

et al. 2016

Med Oral

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BackgroundTemporo-Mandibular Joint (TMJ) replacement has been used clinically for years. The objective of this study was to evaluate outcomes achieved in patients with two different categories of TMJ prostheses.Material and MethodsAll patients who had a TMJ replacement (TMJR) implanted during the study period from 2006 through 2012 were included in this 3-year prospective study. All procedures were performed using the Biomet Microfixation TMJ Replacement System, and all involved replacing both the skull base component (glenoid fossa) and the mandibular condyle.ResultsFifty-seven patients (38 females and 19 males), involving 75 TMJs with severe disease requiring reconstruction (39 unilateral, 18 bilateral) were operated on consecutively, and 68 stock prostheses and 7 custom-made prostheses were implanted. The mean age at surgery was 52.6±11.5 years in the stock group and 51.8±11.7 years in the custom-made group. In the stock group, after three years of TMJR, results showed a reduction in pain intensity from 6.4±1.4 to 1.6±1.2 (p<0.001), and an improvement in jaw opening from 2.7±0.9 cm to 4.2±0.7 cm (p<0.001). In the custom-made group, after three years of TMJR, results showed a reduction in pain intensity from 6.0±1.6 to 2.2±0.4 (p<0.001), and an improvement in jaw opening from 1.5±0.5 cm to 4.3±0.6 cm (p<0.001). No statistically significant differences between two groups were detected.ConclusionsThe results of this three-year prospective study support the surgical placement of TMJ prostheses (stock prosthetic, and custom-made systems), and show that the approach is efficacious and safe, reduces pain, and improves maximum mouth opening movement, with few complications. As such, TMJR represents a viable technique and a stable long-term solution for cranio-mandibular reconstruction in patients with irreversible end-stage TMJ disease. Comparing stock and custom-made groups, no statistically significant differences were detected with respect to pain intensity reduction and maximum mouth opening improvement. Key words:Temporo-mandibular joint, temporo-mandibular joint replacement, prosthesis, biomaterials, biomedical engineering, computer-aided design and manufacturing.

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Section: Discussionmentioning

confidence: 99%

Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study

González-Pérez¹,

Gonzalez-Perez-Somarriba²,

Centeno³

et al. 2016

Med Oral

View full text Add to dashboard Cite

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“…6,[10][11][12][13][14] The main goals of mandibular reconstruction in dogs are the restoration of dental occlusion, mandibular stability, and normal function, which includes physiologic mouth opening and closing and minimal lateral movement (ie, laterotrusion). 6,10,15 People undergoing mandibular reconstruction after mandibular tumor excision have superior function, aesthetics, and quality of life, compared with those who do not undergo mandibular reconstruction, [16][17][18][19][20] and our experience performing mandibular reconstruction suggests that results are similar for dogs. An understanding of normal jaw motion and the effects of mandibulectomy on that motion can provide clinically relevant insight into the complex masticatory changes that occur after mandibulectomy.…”

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confidence: 83%

Kinematic analysis of mandibular motion before and after mandibulectomy and mandibular reconstruction in dogs

Arzi

Verstraete

Garcia

et al. 2019

ajvr

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OBJECTIVE To evaluate and quantify the kinematic behavior of canine mandibles before and after bilateral rostral or unilateral segmental mandibulectomy as well as after mandibular reconstruction with a locking reconstruction plate in ex vivo conditions. SAMPLE Head specimens from cadavers of 16 dogs (range in body weight, 30 to 35 kg). PROCEDURE Specimens were assigned to undergo unilateral segmental (n = 8) or bilateral rostral (8) mandibulectomy and then mandibular reconstruction by internal fixation with locking plates. Kinematic markers were attached to each specimen in a custom-built load frame. Markers were tracked in 3-D space during standardized loading conditions, and mandibular motions were quantified. Differences in mandibular range of motion among 3 experimental conditions (before mandibulectomy [ie, with mandibles intact], after mandibulectomy, and after reconstruction) were assessed by means of repeated-measures ANOVA. RESULTS Both unilateral segmental and bilateral rostral mandibulectomy resulted in significantly greater mandibular motion and instability, compared with results for intact mandibles. No significant differences in motion were detected between mandibles reconstructed after unilateral segmental mandibulectomy and intact mandibles. Similarly, the motion of mandibles reconstructed after rostral mandibulectomy was no different from that of intact mandibles, except in the lateral direction. CONCLUSIONS AND CLINICAL RELEVANCE Mandibular kinematics in head specimens from canine cadavers were significantly altered after unilateral segmental and bilateral rostral mandibulectomy. These alterations were corrected after mandibular reconstruction with locking reconstruction plates. Findings reinforced the clinical observations of the beneficial effect of reconstruction on mandibular function and the need for reconstructive surgery after mandibulectomy in dogs.

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“…In TMJR, this property dictates that the stable component of a TMJR articulation (i.e. the glenoid fossa) is held in position and stabilized by a stronger material (metal) [8].…”

Section: B the Components Of Any Tmjr Device Must Be Stable In Situ mentioning

confidence: 99%

Total Joint Replacement: Biomaterials for Application in the Temporomandibular Joint

2014

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Abstract--End-stage temporo-mandibular joint (TMJ) disease presents a challenging biomechanical problem. The primary function of joint replacement surgery is to relieve pain and restore function, which includes transmitting physiological loads and the provision of both a physiological range of movement and an articulation with minimum friction and wear. It has been demonstrated that the use of appropriate biomaterials and design parameters can decrease material wear and increase the longevity of TMJ replacement (TMJR) devices. Therefore, as with any implanted functioning biomechanical device, surgical revisions may be necessary to remove or replace the articulating components due to material wear or failure. The purpose of this study is to evaluate the criteria for the successful use of TMJR devices and thereby establish a rationale for the use of these devices in the longterm management of end-stage TMJ disorders.Keywords--Cobalt-chromium alloys for surgical implants, ultra-high molecular weight polyethylene for surgical implants, titanium alloys for surgical implants, total joint replacement, temporomandibular joint.

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Mandibular Kinematics in Patients With Alloplastic Total Temporomandibular Joint Replacement—A Prospective Study

Cited by 31 publications

References 37 publications

Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study

Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study

Kinematic analysis of mandibular motion before and after mandibulectomy and mandibular reconstruction in dogs

Total Joint Replacement: Biomaterials for Application in the Temporomandibular Joint

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