Pseudarthrosen im Mund-Kiefer-Gesichts-Bereich

Neff, Andreas; Jung, Jonas P

doi:10.1055/a-0898-4690

Cited by 3 publications

(2 citation statements)

References 37 publications

(83 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, ORIF in condylar fracture has the potential to restore the anatomy and enable normal physiological function of the TMJ if performed well (9,11,50,(76)(77)(78)(79)81,87,89). Well performed ORIF of condylar fractures, should efficiently reduce complication rates and help to avoid late sequelae such as ankylosis (90) and trauma associated condylar resorption (91,92) (videlicet traditional indications for TMJR), but in the first place could prevent ORIF associated complications such as malunion and secondary displacement due to insufficient osteosynthesis (93). This implies that widespread striving for improvement of skills and expertise in ORIF of condylar traumatology is mandatory (87).…”

Section: Discussionmentioning

confidence: 99%

“…(III) The biomechanical demands for stability in condylar process fractures were published more than two decades ago (105,106). Inadequate fixation in condylar neck/base fractures can result in pseudarthrosis/malunion (93) and in extreme cases even total loss of joint functionality (87,107), which may ultimately require TMJR to correct (15). In condylar head fractures, some fixation techniques [e.g., plating procedures (30,108)] have a high potential to promote scarification, loosening of osteosynthesis material etc.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Indications for alloplastic temporomandibular joint replacement in maxillofacial trauma—an analysis of condylar trauma patients with scoping review of the literature

Neff¹,

McLeod²,

Jung³

et al. 2023

Front Oral Maxillofac Med

View full text Add to dashboard Cite

Background: We undertook a review of the literature to assess the role of temporomandibular joint (TMJ) replacement (TMJR) in maxillofacial trauma and examined our own experience of temporomandibular joint bony complications. Methods: A scoping review of (I) a systematic literature research performed for the German evidence and consensus based (S3) guideline on total joint replacement, (II) a recent systematic review and meta-analysis by Niezen et al. [2022] (comprising 13,093 patients and 20,860 prostheses), (III) a systematic literature review of PubMed, google scholar and Cochrane database between November 2021 and February 2022 including English and German studies. In addition, we evaluated our cohort of surgically treated condylar fractures (n=604; head fractures: n=405 since 1993; neck and base fractures: n=199 since 2007) regarding complications which may potentially necessitate a TMJR.Results: Our search identified 8 studies including 10 patients in addition to the 83 cases found by Niezen et al. Although many reports on TMJR describe trauma as an aetiological factor, overall, merely 4 cases received an alloplastic TMJR as a primary treatment. Three cases met the criteria for an early secondary treatment within 6 months, 9 cases after 6 months past trauma. None of the surgically treated condylar fractures (n=604) in our cohort required joint replacement. Within the condylar head dataset (n=405) there was a significant correlation (P<0.05) between the presence of major fragmentation (n=52) and bony complications (n=23, 5.7%) such as osteoarthrosis, pseudarthrosis and heterotopic ossification (HO)/ankylosis. HO (n=9) correlated with delayed surgical treatment (>10-14 days, P<0.01). There was a significant correlation between subjective borderline feasibility of osteosynthesis (n=12/270, 0.4%) and major fragmentation (P<0.001), severe comminution (P<0.001), multilevel fractures (P<0.001) and severe osteoporosis (P<0.001). Conclusions:In contrast to orthopedic practice alloplastic TMJR does not play a noticeable role in primary or early secondary condylar fracture management. There may be indications in selected cases of major fragmented fractures where safe and stable osteosynthesis is not feasible. Most condylar fractures if treated according to best practice should not result in significant bony complications, but those that do may ultimately require further intervention including TMJR.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Indications for alloplastic temporomandibular joint replacement in maxillofacial trauma—an analysis of condylar trauma patients with scoping review of the literature

Neff¹,

McLeod²,

Jung³

et al. 2023

Front Oral Maxillofac Med

View full text Add to dashboard Cite

show abstract

Literatur

2022

Atlas Kiefergelenkserkrankungen

View full text Add to dashboard Cite

Intensive Care as an Independent Risk Factor for Infection after Reconstruction and Augmentation with Autologous Bone Grafts in Craniomaxillofacial Surgery: A Retrospective Cohort Study

Jung

Haunstein

Müller

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

Autologous bone grafts for reconstruction and augmentation are routinely used for maintaining functionality and facial aesthetics. Associated complications, however, have a significant impact on patients and health care systems. This study aims to investigate the possible risk factors associated with the occurrence of complications in order to provide evidence for the outcome of autologous bone graft reconstructive procedures. Patients from 2008 to 2018 who underwent autologous (mostly mandibular) reconstruction were included in the observational study. Clinical, pathological, and therapeutic factors were examined in univariate and multivariate analysis for significance with occurring complications. A multivariate model was used to create a prognostic model predicting the occurrence of complications. Graft complications requiring revision were exhibited by 33/128 patients. Infections were most frequent, with 4/22 patients affected by multi-resistant germs. Multivariate analysis showed radiotherapy (OR = 5.714; 95% CI: 1.839–17.752; p = 0.003), obstructive pulmonary disease (OPD) (OR = 4.329; 95% CI: 1.040–18.021; p = 0.044) and length of defect (in mm) (OR = 1.016; 95% CI: 1.004–1.028; p = 0.009) as independent risk factors associated with graft complications with high accuracy of prediction (AUC = 0.815). Intensive care (OR = 4.419; 95% CI: 1.576–12.388; p = 0.005) with a coefficient between intensive care and OPD (0.214) being low was identified as the most relevant risk factor for infection. Although intensive care is not a classic risk factor, but rather a summation of factors not reaching significance in the individual case, a stay in ICU (intensive care unit) needs to be considered for graft complications. As a clinical consequence, we recommend using the best possible hygienic measures during procedures e.g., while performing dressing and drainage changes in ICU.

show abstract

Pseudarthrosen im Mund-Kiefer-Gesichts-Bereich

Cited by 3 publications

References 37 publications

Indications for alloplastic temporomandibular joint replacement in maxillofacial trauma—an analysis of condylar trauma patients with scoping review of the literature

Indications for alloplastic temporomandibular joint replacement in maxillofacial trauma—an analysis of condylar trauma patients with scoping review of the literature

Literatur

Intensive Care as an Independent Risk Factor for Infection after Reconstruction and Augmentation with Autologous Bone Grafts in Craniomaxillofacial Surgery: A Retrospective Cohort Study

Contact Info

Product

Resources

About