Temporomandibular joint arthroplasty for osteoarthrosis: A series of 24 patients that received a uni- or bilateral inter-positional silicone sheet

Abstract

The poor reputation of prosthetic discoplasty was not as evident in our series, even though anatomical and functional status seemed to deteriorate over time. This is because total-joint prosthetic replacement is often proposed instead. However, for elderly or fragile patients that have severe pain, and regarding cost-benefit aspects, conventional arthroplasty can still be discussed, especially since French national health-care insurance does not yet support TMJ prosthetic replacement for osteoarthrosis.

Osteoarthritis of the Temporomandibular Joint: A Narrative Overview

“…The main clinical signs of TMJOA are joint noise (crepitus), loss of function with limited mouth opening, and pain [ 7 , 21 , 22 ]. Pain can be continuous and is aggravated during mastication [ 21 ].…”

“…The main clinical signs of TMJOA are joint noise (crepitus), loss of function with limited mouth opening, and pain [ 7 , 21 , 22 ]. Pain can be continuous and is aggravated during mastication [ 21 ]. Although these clinical signs are suggestive of TMJOA, the diagnosis is mainly radiological [ 10 , 32 ], with signs of cortical bone erosion, flattening of joint compartments, sclerosis, osteophyte formation, and subcortical cyst formation [ 5 , 10 ].…”

Degenerative bony changes in the temporal component of the temporomandibular joint – review of the literature

“…However, the term arthrosis emphasizes the reduction of the cartilage resulting in consequent alterations at the bone level [29]. Earlier articles describe OA as an inflammatory condition within the joint that results from a degenerative condition and osteoarthrosis as a degenerative disorder of the joint with abnormal joint form and structure [9,30].…”

“…In other papers, 'osteoarthritis' was depicted as a lowinflammatory arthritic disorder, generated by a wide variety of factors, either inflammatory or not [29,31], while TMJ degenerative alterations similar to those seen in OA, caused by any low-inflammatory/non-inflammatory arthritic afflictions were defined as osteoarthrosis [31]. However, as the basic etiology, pathology and even treatment are similar, osteoarthrosis and OA are quite frequently confused with one another or even sometimes used as synonyms in the dental TMJ literature [29,31].…”

“…Also, although degenerative TMJ changes were more frequently associated with skeletal jaw discrepancies, wide variations were reported in cases with relatively similar malocclusions [16]. TMJ degenerative changes could be multifactorial and might be caused by a wide variety of possible factors: genetic factors [42], gender, dietary loading [43], tooth loss, tooth attrition, occlusal disturbances, TMJ overloading, congenital abnormality (congenital condyle dysplasia), inflammation [44], trauma, ageing [15], bruxism, unilateral chewing, and internal derangement [23,28,29,[45][46][47][48].…”