Will they fit? Determinants of the adaptability of stock TMJ prostheses where custom TMJ prostheses were utilized

Brown, Zachary; Sarrami, Shayan M.; Pérez, Daniel

doi:10.1016/j.ijom.2020.05.009

Cited by 17 publications

(6 citation statements)

References 12 publications

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“…In a study published by our institution (Brown et al [22]), with the aim of evaluating whether or not a stock prosthesis could have been used to reconstruct a TMJ previously reconstructed with a custom device, we found that 40% of the reconstructed joints had concomitant orthognathic surgery and of those, 60% could have used a stock prosthesis. However, most of the patients who might have been able to be treated with a stock prosthesis did not have significant maxillary compensations to correct and underwent minimal mandibular advancements.…”

Section: Device Selection (Stock Vs Custom)mentioning

confidence: 90%

Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery

Amarista

Pérez

2023

Diagnostics

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The treatment of patients with severe temporomandibular joint (TMJ) disorders and associated skeletal discrepancies presents a complex challenge for oral and maxillofacial surgeons. It is widely recognized that TMDs can impact the stability and outcomes of surgical treatments for dentofacial deformities. Consequently, addressing TMDs prior to or in conjunction with orthodontic or surgical interventions may be necessary to achieve optimal and long-lasting results. Alloplastic temporomandibular joint replacement (TMJR) and orthognathic surgery have emerged as the standard approach due to their predictability, long-term stability and excellent outcomes when addressing end-stage TMJ disease in conjunction with DFDs as it provides a comprehensive solution to address both functional and aesthetic aspects of these patients’ conditions. Understanding the appropriate utilization of TMJR in conjunction with orthognathic surgery can lead to improved treatment planning and successful outcomes for patients with complex TMJ disorders and associated dentofacial deformities. This review aims to discuss the indications, preoperative evaluation, staging, sequencing, and surgical considerations involved in utilizing alloplastic TMJ replacement in the presence of dentofacial deformities.

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Section: Device Selection (Stock Vs Custom)mentioning

confidence: 90%

Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery

Amarista

Pérez

2023

Diagnostics

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“…An effective method for achieving rapid improvements in mouth opening and pain reduction is TMJ reconstruction using an alloplastic total prosthetic joint replacement (TJR). This invasive approach is still considered the last resort for the treatment of TMD [27][28][29][30][31][32][33].…”

Section: Major Clinical Outcomesmentioning

confidence: 99%

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Gubert,

Mercante,

Polidoro

et al. 2024

MedNEXT

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Introduction: The temporomandibular joint (TMJ) can be affected by end-stage pathologies, such as arthritic disease, trauma, and ankylosis. Around 70% of the general population has suffered at least one symptom of temporomandibular disorder (TMD), which constitutes TMJ disease that may be related to the joints, muscles, ligaments, bones, teeth, and psychological aspects. As a treatment, the implantation of a total alloplastic TMJ prosthesis is an innovative approach. Objective: It was to present the main considerations and outcomes of clinical studies on the treatments of temporomandibular disorders using customized or prefabricated prostheses. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found, 40 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=57.8%>50%. It was concluded that stock and CAD/CAM prostheses suggested great improvements in mouth opening and pain reduction as a result of the rehabilitation of TMJ function. The results showed comparable data for both types of prosthesis design at 6 months postoperatively. However, the additional advantages of custom prosthetics, along with increasing access to digital technology, will likely result in custom devices dominating the market in TMJ total joint replacement systems. The custom-made combined prosthesis with custom design and 3D printing fabrication represents a safe and reliable implantable reconstruction method for combined TMJ-skull base injuries.

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“…The screws' positioning in the prosthetic articular fossa and in the mandible ramus also promotes a shorter surgical time once osteoplasty is not required [50]. The main disadvantages of custom-made TMJ TJR prostheses are the costs, the manufacturing time, and the bureaucratic process for government authorization in some countries [22,39,49,52,53]. Considering the customized TMJ TJR components are well-fitted to the anatomic features of the patient, the temporomandibular recovery is enhanced, decreasing risks of failures, postsurgical issues, and discomfort to the patient [43,54].…”

Section: Standard and Custom-made Tmj Tjr Prosthesesmentioning

confidence: 99%

A Preliminary Analysis of the Wear Pathways of Sliding Contacts on Temporomandibular Joint Total Joint Replacement Prostheses

Pinto-Borges

Carvalho

Henriques

et al. 2021

Metals

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In the last years, several materials and design have been assessed in an attempt to improve the mechanical performance of temporomandibular joint total joint replacement (TMJ TJR) prostheses. However, the wear of the TMJ TJR condyle to the polymer-based fossa component during loading and sliding movements. That promotes the release of debris and risks of toxicity to the surrounding tissues. The purpose of this study was to perform a narrative literature review on the wear of TMJ TJR sliding contacts and potential toxicity of metallic debris to the patients. Previous studies reported a significant deterioration of the sliding contact surfaces of TMJ TJR prostheses. Material loss as a result of wear can cause a TMJ TJR condyle/fossa mismatch and the modification of the contact pressure and chewing loading. As a further consequence of wear, metal particles are released to the surrounding tissues with a high risk of local tissue and systemic toxicity through the bloodstream. The presence of particles induces the stimulation of inflammatory reactions depending on the concentration and size of debris. Thus, CoCr-based condyle release metallic ions and sub-micron particles that can be engulfed by macrophages or internalized by other tissue cells. The wear and material loss of TMJ TJR could be decreased by design optimization and novel materials with low friction and contact pressure. That consequently decrease the amount of metallic ions and particles to the surrounding tissues, preventing peri-prosthetic inflammatory reactions.

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Will they fit? Determinants of the adaptability of stock TMJ prostheses where custom TMJ prostheses were utilized

Cited by 17 publications

References 12 publications

Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery

Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

A Preliminary Analysis of the Wear Pathways of Sliding Contacts on Temporomandibular Joint Total Joint Replacement Prostheses

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