“…According to the study done by Kaban et al, 36 Roychoudhury et al, 37 mercuri et al, 38 aggressive physiotherapy plays a crucial role in preventing the heterotopic bone formation around the joint in the early postoperative period. The most critical period in which the highest quantity of heterotopic bone is formed is during the rst 3 months after surgery.…”
Objective: The purpose of this longitudinal study was to surveil the serum titanium ion levels at various time intervals in patients with indigenous 3D-printed total temporomandibular joint replacement (TMJ TJR).
Study design: The study was conducted on 11 patients (male: 8; female: 3) who had undergone unilateral or bilateral TMJ TJR. Blood samples were drawn preoperatively (T0), 3 months (T1), 6 months (T2), and 1 year (T3) postoperatively. Data were analyzed and a p value of <0.05 was considered statistically significant.
Results: The mean serum titanium ion levels at T0, T1, T2, and T3 was 9.34 ± 8.70 microgram/L (mcg/L), 35.97 ± 20.27 mcg/L, 31.68 ± 17.03 mcg/L, and 47.91 ± 15.47 mcg/L respectively. The mean serum titanium ion levels increased significantly at T1 (p= 0.009), T2 (p= 0.032), and T3 (p=0.00) interval. There was no significant difference between unilateral and bilateral groups.
Conclusion: Serum titanium ion continued to show increased levels till the last follow-up of 1 year. These initial serum titanium ion levels increase is due to the initial wear phase of the prosthesis which manifests over 1 year. Further studies with large sample sizes and long-term follow-ups are required to see the deleterious effect if any on the TMJ TJR.
“…According to the study done by Kaban et al, 36 Roychoudhury et al, 37 mercuri et al, 38 aggressive physiotherapy plays a crucial role in preventing the heterotopic bone formation around the joint in the early postoperative period. The most critical period in which the highest quantity of heterotopic bone is formed is during the rst 3 months after surgery.…”
Objective: The purpose of this longitudinal study was to surveil the serum titanium ion levels at various time intervals in patients with indigenous 3D-printed total temporomandibular joint replacement (TMJ TJR).
Study design: The study was conducted on 11 patients (male: 8; female: 3) who had undergone unilateral or bilateral TMJ TJR. Blood samples were drawn preoperatively (T0), 3 months (T1), 6 months (T2), and 1 year (T3) postoperatively. Data were analyzed and a p value of <0.05 was considered statistically significant.
Results: The mean serum titanium ion levels at T0, T1, T2, and T3 was 9.34 ± 8.70 microgram/L (mcg/L), 35.97 ± 20.27 mcg/L, 31.68 ± 17.03 mcg/L, and 47.91 ± 15.47 mcg/L respectively. The mean serum titanium ion levels increased significantly at T1 (p= 0.009), T2 (p= 0.032), and T3 (p=0.00) interval. There was no significant difference between unilateral and bilateral groups.
Conclusion: Serum titanium ion continued to show increased levels till the last follow-up of 1 year. These initial serum titanium ion levels increase is due to the initial wear phase of the prosthesis which manifests over 1 year. Further studies with large sample sizes and long-term follow-ups are required to see the deleterious effect if any on the TMJ TJR.
Background
The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management.
Methods
An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes.
Results
The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols.
Conclusion
This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes.
“…The published literature summarized in Table 1 appears Trauma [17]; chronic arthritis [2]; osteochondroma [1]; syndromes [3]; ankylosing spondylitis [1]; failed previous reconstruction [1]; unknown [3]; TMJ disorder [1]; iatrogenic [3] 59.5 [12-168] 14.5 [6.3-20] 35 [30][31][32][33][34][35][36][37][38][39][40] 20.5 TMJ concepts Heterotopic bone [2]; hardware loosening in syndromic patient [1]; infection [1]; reankylosis [ Occlusal discrepancy [2]; infection [1]; intraoral ramal component exposure [1]; pain and reduced mouth opening [1] Roychowdhury et al, 2021 (31) Prospective cohort 41 25.12 Trauma [30]; infection [7]; ankylosing spondylitis [1]; unknown [3] , this study included 20 patients, 18 of whom had ankylosis, but individual data for ankylosis was not included. We decided to include this despite lack of ankylosis-specific data; ‡ , these articles may present some of the same subjects, as the two studies are from the same author over the same time period; § , this study used a stainless steel prosthesis with nonstandard techniques and fixation; ¶ , these articles may have some overlap of subjects, as they are retrospective studies of similar patient criteria from the same institution in overlapping time periods; *, reankylosis in this case developed around the coronoid, and not necessarily the TJR prosthesis itself.…”
Background: Temporomandibular joint (TMJ) ankylosis affects children and adults throughout the world and causes dramatic loss of jaw function and poses problems for safe airway management. Treatment may represent a challenge due to risks of recurrence of ankylosis or morbidity of surgery. Alloplastic joint reconstruction presents a solution that eliminates donor site morbidity and provides predictable outcomes.Various reports and studies of alloplastic reconstruction have been published, but relatively few have focused specifically on the treatment of patients with ankylosis of the TMJ. The objective of this study is to review literature specifically addressing outcomes for treatment of TMJ ankylosis with total alloplastic reconstruction.
Methods:The authors conducted a comprehensive search of several databases from 1990 to January 2022 to identify trends and general outcomes in the treatment of TMJ ankylosis via alloplastic joint reconstruction. There were no language restrictions. Only human studies were included. Evaluations included the type of study, outcomes reported in terms of improved function, and surgical complications.In addition, the authors conducted a retrospective review of Mayo Clinic patients undergoing alloplastic total TMJ joint reconstruction for treatment of TMJ ankylosis to determine outcomes at our institution and ascertain whether or not they are comparable to the world literature.Results: Thirty studies met inclusion criteria, reporting on 398 joint reconstructions. The most common etiologies were trauma and infection. Treatment resulted in improved range of motion, with means ranging from 9.3 to 40.8 mm. Adverse events were relatively uncommon, and only one case of re-ankylosis was reported. The authors' case series found 10 subjects meeting criteria for inclusion. The most common precipitating factor was prior discectomy. Mean improvement in MIO was 22 mm, with no cases of reankylosis.Conclusions: Alloplastic total TMJ reconstruction with FDA-approved devices is a safe and predictable treatment with a very low risk of re-ankylosis.
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