Temporomandibular joint alloplastic reconstruction of post-traumatic joint degeneration with Sawhney Type I ankylosis using 3D-custom GD-condylar cap prosthesis to restore condylar form and function

Koneru, Ganesh; Bhargava, Darpan; Somuri, Anand Vijay; Manoj, M K; Nesan, John; Pillai, Ajay; Beena, Sivakumar

doi:10.1016/j.jormas.2020.09.002

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…A third patient received a Christensen total joint early after a failed ORIF in a subcondylar fracture (41), the latter case thus fitting to our PICOTS criteria. A case receiving a customized TMJR with a Sawhney's type I ankylosis reported by Koneru et al again was a secondary TMJR 6 months after failed conservative condylar fracture treatment with a modified total alloplastic joint using a patient specific titanium cap over the shortened condyle with a very flat UHMPWE fossa (40). Other reports including e.g., central dislocation in the middle cranial fossa (39,64) did not meet our inclusion criteria.…”

Section: Discussionmentioning

confidence: 96%

“…In summary, a total of 13 publications including 16 patients were identified by the various search approaches and included in the review (Table 3) (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Four of the patients received an alloplastic reconstruction other than a total joint replacement as a primary treatment following a condylar fracture (36)(37)(38).…”

Section: Literature Searchmentioning

confidence: 99%

“…In 9 cases TMJR was done within a time frame greater than 6 months post fracture (39,(42)(43)(44)(45)(46)(47)(48). Therefore, only three patients (secondarily treated with TMJR within 6 months post fracture) sufficiently met the PICOTS criteria (39)(40)(41). No study describing the use of total TMJR as a primary (that is, immediate) treatment option for condylar fractures was identified by the various search approaches.…”

Section: Literature Searchmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 96%

Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

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

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Total Temporomandibular Joint Replacement by Samsid Customized Joint Prosthesis: A Case Report with 16 Years of Follow-Up

Chaware

2024

Indian J Plast Surg

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Total temporomandibular joint replacement (TMJR) is a surgical intervention employed for the management of advanced temporomandibular joint (TMJ) disorders, particularly when autogenous grafts are not recommended. With stainless steel implant of glenoid fossa attempted for the correction of ankylosis in the 1960s, total TMJR—which minimizes foreign body reaction and consists of highly biocompatible materials such as Cr-Co-Mo alloy, titanium, and ultra-high-molecular-weight polyethylene—began to be applied. These alloplastic prostheses are available in both standardized and customized forms, comprising components for the mandibular condyle and glenoid fossa. The present case report presents India's first TMJR in a 12-year-old female patient with TMJ ankylosis. Total TMJR was done in her with India's first customized TMJ prosthesis (Samsid TMJ prosthesis), which was designed and manufactured by the author for the first time in India. This study presents a 16-year follow-up of customized TMJR, addressing TMJ ankylosis. Our research showcases the long-term success of Samsid TMJ prostheses in improving pain, oral function, diet, and overall quality of life. The case report also highlights the potential of Samsid TMJ prostheses as a valuable solution for TMJ patients, emphasizing the importance of tailored solutions for lasting joint function restoration. The results presented indicate that the Samsid patient-fitted total TMJR system remains a secure, efficient, and dependable long-term treatment option for the particular patient demographic examined in this research.

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Custom-Made Alloplastic Prosthetic Implant to Treat Temporomandibular Joint Ankylosis in Pediatric Patients: A Case Study

et al. 2021

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Temporomandibular Joint (TMJ) ankylosis represents a fairly common condition which surgeons need to face. According to Rowe, it can be defined as a restricted functional capacity of the jaw with limited movements owing to bony or fibrous adhesions between the condyle and either glenoid fossa, disc or eminence (or both). It can become a disease which impacts patients’ daily life, who suffer from limited mandibular excursion with reduced intercisal opening, anterior open bite, inability to swallow, sleep disorders, and speech problems. In children this may also result in abnormal mandibular and facial growth. In this paper, we deal with the case of a child with an important momolateral ankylosis, previously treated surgically with Costochondral Grafting arthroplasty without success and subsequently treated with a custom-made prosthesis.

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Temporomandibular joint alloplastic reconstruction of post-traumatic joint degeneration with Sawhney Type I ankylosis using 3D-custom GD-condylar cap prosthesis to restore condylar form and function

Cited by 3 publications

References 8 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

Total Temporomandibular Joint Replacement by Samsid Customized Joint Prosthesis: A Case Report with 16 Years of Follow-Up

Custom-Made Alloplastic Prosthetic Implant to Treat Temporomandibular Joint Ankylosis in Pediatric Patients: A Case Study

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