Stability of the Natural Joint Side in Unilateral Alloplastic Total Temporomandibular Joint Replacement Using a Ready-Made System

Abstract

An alloplastic total joint replacement (TJR) is an effective and reliable treatment option in non-salvageable end-stage temporomandibular joint (TMJ) disease. However, unilateral alloplastic TJR of the TMJ (TMJ TJR) could affect the other side natural joint because the physiologic action of both condyles is quite different during mandibular movement. In this study, we examined whether the unilaterally replaced alloplastic TMJ TJR affects the other side natural joint condition over long periods of time. Eight patients who received alloplastic TJR on one side were subjects in this study. All alloplastic TJR implants were stable in situ. The average maximum mouth opening was 37.5 mm (range 19–49 mm) pre-operatively and 44.1 mm (range 34–57 mm) post-operatively. This parameter gradually increased and reached the maximum at about twelve months after surgery. The post-operative change of pain level was significantly reduced from 3.5 to 0 on a pain scale of zero to ten. No significant complications in any joints were observed within the follow-up period. The shape of the natural joint sides showed slight changes but were functionally stable during the observation period. In this study, unilateral alloplastic TJR showed stable and reliable clinical results, either alloplastic TJR or healthy joint sides for quite long period of time.

Muscle and joint mechanics during maximum force biting following total temporomandibular joint replacement surgery

“…Unilateral total TMJR surgery is associated with degradation of the native contralateral TMJ. It changes the morphology of the native joint (Kim et al 2021 ) and leads to subsequent bilateral total TMJR surgery in up to 40% of cases (Franco et al 1997 ). Previous investigations have speculated that this is due to altered loading patterns resulting from hypermobility of the native joint (Leiggener et al 2012 ) or joint overloading (Perez et al 2016 ).…”

Muscle and Joint Mechanics During Maximum-Force Biting Following Total Temporomandibular Joint Replacement Surgery

“…Unilateral total TMJR surgery is associated with degradation of the native contralateral TMJ, this changes the morphology of the native joint (Kim et al 2021) and leads to subsequent bilateral total TMJR surgery in up to 40% of cases (Franco et al 1997). Previous investigations have speculated that this is due to altered loading patterns resulting from hypermobility of the native joint (Leiggener et al 2012), or joint overloading (Perez et al 2016).…”

Biomechanical Evaluation of Temporomandibular Joint Reconstruction Using Individual TMJ Prosthesis Combined with a Fibular Free Flap in a Pediatric Patient

“…Reconstruction surgeries performed entirely with the use of fibular free flaps are not functionally adequate, taking into consideration the high risk of developing ankyloses and other complications [13]. Incorrect functioning of the reconstructed temporomandibular joint may also negatively affect the opposite joint, causing damage to the joint, which often requires surgical intervention [14,15].…”