Successful Reconstruction of Nongrowing Hemifacial Microsomia Patients With Unilateral Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Wolford, Larry M.; Bourland, T. Campbell; Rodrigues, Daniel B.; Pérez, Daniel; Limoeiro, Evelin

doi:10.1016/j.joms.2012.02.010

Cited by 53 publications

(48 citation statements)

References 29 publications

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“…The concept and technique of using TMJ TJP for TMJ reconstruction and simultaneous mandibular advancement with counterclockwise rotation of the maxillomandibular complex was developed by Wolford et al in 1990 and was first used for HFM in 1997 [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of the Adult Hemifacial Microsomia Patient with Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Cascone

Vellone

Ramieri

et al. 2018

Case Reports in Surgery

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Background HFM patients' reconstruction has always been a challenge for maxillofacial surgeons, and numerous reconstructive techniques have been described. Surgical treatment depends on the patient's age and contemplates Temporomandibular Joint (TMJ) reconstruction in conjunction with orthognathic surgery, usually necessary following completion of growth to maximize the functional and esthetic results. Distraction osteogenesis had gained popularity as valid alternative in growing patients, but the two primary methods to reconstruct the TMJs involve the use of autogenous, using free or microvascular bone grafts, or alloplastic graft, but there is no widely accepted method. Methods The increasing use of temporomandibular prosthesis for temporomandibular problems has led us to use them even in HFM. A case of female nongrowing patients with HFM type IIb treated with temporomandibular prosthesis in an all-in-one protocol is presented. Results Incisal opening, measured with BioPAK system (Bioresearch Inc., Milwaukee, USA), was 21.4 mm in the presurgical period and 32.2 mm after all-in-one procedure, for an increase of 50.5%. Excursive movement to the right side was 2.2 mm in the presurgical period and was 1.5 mm after surgery, for a decrease of 31.8%. Left excursion movement changed from 5 mm to 6.1 mm, for an increase of 22.0%. Conclusions The TMJ Concepts patient-fitted TJP in conjunction with orthognathic surgery for TMJ and jaw reconstruction is a valid option for patients with HFM.

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Section: Discussionmentioning

confidence: 99%

“…The development of custom-fitted total joint prosthesis (TJP) provides an additional option to aid in reconstruction of the HFM patient in conjunction with orthognathic surgical procedures [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of the Adult Hemifacial Microsomia Patient with Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Cascone

Vellone

Ramieri

et al. 2018

Case Reports in Surgery

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“…patientenspezifischer Implantate sind die technisch nahezu unbegrenzten Möglichkeiten zur Erweiterung und Anpassung an über die Gelenkregion hinaus bestehende Defekte. Patienten mit Gelenkfortsatzdefekten bei HFM wurden in den ersten Erfolgsberichten über extendierte TMJ-TJRs genannt [1,9,68], wobei auf die anatomiegerechten 3-dimensionalen Rekonstruktionsmöglichkeiten hingewiesen wurde.…”

Section: Diskussion Zusammenfassung Und Fazitunclassified

Kombination von Kiefergelenkersatz und Rekonstruktionen in der Unterkieferkorpus- oder Jochbeinregion mit erweiterten maßgefertigten Endoprothesen

Cornelius¹,

Ehrenfeld²,

Mast³

et al. 2014

OP-JOURNAL

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Zusammenfassung Heutzutage gilt der totale alloplastische Kiefergelenkersatz bei Pathologien mit irreversiblen Form- und Dimensions?nderungen des Processus condylaris mandibulae als verl?ssliche Behandlungsoption. Bei Defekten, die ?ber den Gelenkfortsatz und die Gelenkgrube hinaus weitere Unterkiefereinheiten und/oder die Jochbogen/Jochbeinregion involvieren, l?sst sich das Design individuell gefertigter Endoprothesen so gestalten, dass benachbarte Knochendefizite ausgeglichen werden k?nnen. Alloplastische Rekonstruktionen dieser Art kommen infrage, wenn autologe Rekonstruktionsverfahren mit erheblichem Zusatzaufwand verbunden oder nicht durchf?hrbar sind. W?hrend die anatomische Form und Konturgebung in ?sthetisch und funktionell befriedigender Weise wiederhergestellt werden k?nnen, darf von einem alloplastischen Gelenkersatz mit Reduktion auf eine einfache Biomechanik von vornherein nicht erwartet werden, die Bewegungsabl?ufe und Interaktionen innerhalb des komplexen stomatognathen Systems vollkommen zu replizieren.

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“…The challenges of reconstructing the severe grades of hemifacial microsomia are well recognized. Numerous protocols for autogenous reconstruction have been advanced (Pruzansky, 1969; Kaban et al, 1988; Munro et al, 1989; McCarthy, 1994; Wolford et al, 1994a; Mercuri and Hurder, 2004; Wolford et al, 2012; Tahiri et al, 2015; Wolford and Perez, 2015). Unfortunately, these have not been substantiated through a series of patients treated with consistently acceptable results.…”

Section: Introductionmentioning

confidence: 99%

Salvage or Solution: Alloplastic Reconstruction in Hemifacial Microsomia

Polley

Girotto

Fahrenkopf

et al. 2018

The Cleft Palate-Craniofacial Journal

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Introduction: Skeletal reconstruction in severe grades of hemifacial microsomia (HFM) continues to be challenging. Traditional techniques of autografts and osseous distraction for reconstruction of the glenoid fossa, condyle, and ramus can fall short of expectations and can create new problems. This intercontinental study analyzes the role of alloplastic skeletal rehabilitation in severe HFM. Methods: Ten consecutive patients with Pruzansky grade III HFM were reconstructed between October 2014 and July 2017 at 2 craniofacial centers following the same protocol. Data were gathered retrospectively from the medical records, including photographs and virtual planning records. Pre and postoperative photos were taken to compare occlusal status, interincisal opening, sagittal mandibular projection, and posterior facial height. Alloplastic reconstruction was accomplished using a custom designed titanium implant. Results: Ten consecutive skeletally mature patients with HFM with failed traditional reconstructions were successfully treated with virtually planned alloplastic reconstructions (11 joints) and simultaneous orthognathic surgery. The glenoid fossa, condyle, and ramus on the affected sides were reconstructed with custom designed titanium implants. All patients achieved occlusal stabilization, normalization of posterior facial height and sagittal mandibular projection, and maintenance or improved inter-incisal opening. There were no major complications or repeated surgeries. Follow-up ranges from 6 to 50 months. Conclusion: Alloplastic reconstruction allows for precise vertical reconstruction of the ramus and condyle and sagittal repositioning of the mandibular body. The glenoid fossa component is firmly anchored to the skull base assuring a stable centric relation on the reconstructed side. Consistent and acceptable results can be achieved in skeletally mature patients.

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Successful Reconstruction of Nongrowing Hemifacial Microsomia Patients With Unilateral Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Cited by 53 publications

References 29 publications

Reconstruction of the Adult Hemifacial Microsomia Patient with Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Reconstruction of the Adult Hemifacial Microsomia Patient with Temporomandibular Joint Total Joint Prosthesis and Orthognathic Surgery

Kombination von Kiefergelenkersatz und Rekonstruktionen in der Unterkieferkorpus- oder Jochbeinregion mit erweiterten maßgefertigten Endoprothesen

Salvage or Solution: Alloplastic Reconstruction in Hemifacial Microsomia

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