Alloplastic Reconstruction of the Temporomandibular Joint

Abstract

Temporomandibular joint reconstruction (TMJR) is often necessary for patients with severe and/or refractory TMJ disease who have failed conservative treatment. TMJR aids to improve masticatory function and is associated with improved quality of life outcomes. Currently, alloplastic reconstruction is considered as the treatment of choice in most severe TMJ disorders due to its many advantages inclusive but not limited to early mobilization, stable longterm results, and significant improvement in jaw function. Broadly speaking, two types of TMJR prostheses are available for reconstruction: 1) stock, and, 2) custommade prostheses. The purpose of this article is to provide the reader with a brief overview of the basic principles and fundamentals of TMJR while referencing pertinent existing literature.

In Vitro Biomechanical Simulation Testing of Custom Fabricated Temporomandibular Joint Parts Made of Electron Beam Melted Titanium, Zirconia, and Poly-Methyl Methacrylate

“…This is in coherence with a recent review about the biomechanical properties of different total TMJ replacement systems evaluated through finite-element analysis, and reported lower stress values for customized TMJ components [41]. Furthermore, anatomically mirrored prosthetic condyle and glenoid fossa elements enables their close approximation to the native bone and could facilitate enhanced osseointegration [8]. However, the present outcomes must be considered in light of the following limitations.…”

“…Total alloplastic TMJ replacement systems have become the clinical norm, rather than an exception, for management of refractory end stage TMJ disease and severe functional impairment due to pathological processes [8]. They are reported to improve the post-operative quality of life for patients, through pain alleviation, enhanced range of motion, and better speech and mastication [25].…”

“…The idea of total alloplastic TMJ reconstruction is definitely motivated from the clinical success of similar procedures in orthopedic surgery for more than half a century [8,25,26]. As a result of which, the concept of ball (condyle) and socket (glenoid fossa) articulating components have been largely favored in both stock and custom-fitted alloplastic TMJs [8,21].…”

“…The idea of total alloplastic TMJ reconstruction is definitely motivated from the clinical success of similar procedures in orthopedic surgery for more than half a century [8,25,26]. As a result of which, the concept of ball (condyle) and socket (glenoid fossa) articulating components have been largely favored in both stock and custom-fitted alloplastic TMJs [8,21]. In addition, eliminating translational joint movement, the ball and socket TMJ design is routinely fabricated with a short condylar component and thick glenoid fossa component, in order to match with the low center of rotation of the natural joint [21,28].…”

Reconstrução de ATM por meio de prótese aloplástica customizada após ressecção de ameloblastoma: relato de caso

“…A literatura descreve dois tipos de reconstrução de ATM, a substituição autógena e a aloplástica. ( Dang et al 2017) Entretanto, há necessidade de um segundo sítio cirúrgico o que pode ocasionar maior risco de complicação e aumento de morbidade; há necessidade de uma equipe profissional de outras áreas para colher o enxerto; cirurgia mais longas e potencial de falha devido à presença de reação de corpo estranho ou doença inflamatória. (Dang et al, Op.…”