Analysis of outcomes after revision replacement of failed total temporomandibular joint prostheses

Gakhal, Manpreet; Gupta, Benjamin; Sidebottom, Andrew J.

doi:10.1016/j.bjoms.2019.12.009

Cited by 16 publications

(9 citation statements)

References 18 publications

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“…The most frequent reasons for revision or replacement when necessary seem to be infection and recurrence of ankylosis with heterotopic ossification. 29,30 In this study, we have up to 12 years of follow-up for some patients and none of the total TMJ prostheses of the 17 patients required replacement due to wear.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life After Total Temporomandibular Joint Prothesis Surgery

Beret¹,

Nicot

Gutman

et al. 2022

Journal of Craniofacial Surgery

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Introduction: Total temporomandibular joint (TMJ) prostheses are increasingly used in patients with joint destruction presenting significant pain and mouth opening limitation. This surgery can be considered as the last resort solution whose goal is to restore the mandible function. The aim of this study was to evaluate the patient quality of life (QoL) before and after TMJ replacement surgery with a total TMJ prosthesis, using a modified QoL scale. Materials and Methods: All patients with a total uni or bilateral TMJ prosthesis who could be contacted were included. All patients completed 2 retrospective questionnaires: once relative to the preoperative QoL and another for the post-operative QoL, including the assessment of mouth opening limitation, daily eating difficulties and also a QoL score, adapted from the TMJ-QoL questionnaire. Results: A total of 17 patients were included: 13 temporomandibular ankylosis, 3 condylar resorptions and 1 congenital malformation. Mouth opening limitation and daily eating difficulties were significantly reduced after surgery (P < 0.001). Nine of the 11 QoL questions showed a significant decrease in score and thus an improvement of the QoL after surgery: having a conversation (P = 0.006), eating (P < 0.001), yawning (P < 0.001), sleeping ( P = 0.043), recreational activities (P = 0.005), relaxing (P= 0.021), feeling depressed because of TMJ problems (P = 0.032), daily activities (P = 0.008) and patient self-assessment of QoL (P = 0.003). Two showed no significant difference: taking analgesics, and social life. Total score of QoL showed a significant improvement (P= 0.003). Conclusions: Quality of life, mouth opening, and daily eating were significantly improved after total TMJ prosthesis, in agreement with the litterature. The TMJ prosthesis could be considered ealier in the management of end-stage temporomandibular disease.

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Section: Discussionmentioning

confidence: 99%

Quality of Life After Total Temporomandibular Joint Prothesis Surgery

Beret¹,

Nicot

Gutman

et al. 2022

Journal of Craniofacial Surgery

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“…The osteosynthesis screws used are made of titanium alloy by all well-known manufacturers [ 5 ]. And although current guidelines of European professional societies mention the risks of screw loosening and fracture, especially in the case of strong muscular hyperactivity [ 6 ], these events are extremely rare to not described at all in the literature for patient-specific/custom-made prostheses/implants [ 1 , 5 , 7 ]. PSI-TJRs are believed to allow less micromovement at the implant–bone interface due to their higher fitting accuracy based on high-resolution imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

Technical report and rare case description—patient-specific spacer made of bone cement for the revision of a PSI-TMJ fossa after screw fracture

Thiem

Al‐Nawas

Kämmerer

2021

Journal of Surgical Case Reports

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Total alloplastic temporomandibular joint replacement (TMJ-TJR) has once again become the focus of therapy for end-stage destroyed joints. Although material quality has increased significantly in terms of service life and wear, problems occur even with patient-specific (PSI) prostheses. Here, mainly the ramus components are affected and an occurrence of screw loosening or fractures in the area of the fossa of stock joints is rare and has not yet been described for patient-specific (PSI) components. Although very rare, such events pose a great challenge to both practitioners and affected patients, especially in the case of PSI components, not least due to the long time required for new fabrication. The case report shows a non-described screw fracture of a PSI-TMJ fossa and the first description of a temporary revision using a PSI-TMJ fossa made of bone cement.

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“…Gakhal et al 357 analyzed outcomes after revision replacement of failed total TMJ prostheses. While endstage TMJ disease can be managed with alloplastic total joint replacements, these prostheses can fail secondary to allergy, infection, wear, fracture, and heterotopic bone development.…”

Section: Painmentioning

confidence: 99%