Temporomandibular joint reconstruction

Imola, Mario J.; Liddell, Aaron

doi:10.1097/moo.0000000000000282

Cited by 17 publications

(16 citation statements)

References 58 publications

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“…Current modalities of the temporomandibular joint reconstruction include: costochondral grafting, revascularized tissue transfer, distraction osteogenesis and alloplastic temporomandibular joint replacement (APTMJR) [95]. The most severe cases, including advanced osteoarthritis or temporomandibular joint arthrosis, are treated with total temporomandibular joint replacement [96].…”

Section: Open Joint Surgerymentioning

confidence: 99%

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

2020

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Background and objectives: There is an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.

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Section: Open Joint Surgerymentioning

confidence: 99%

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

2020

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“…2 Pedicled extranasal flaps such as PCF also provide enough surface area to cover the entire ventral skull base. 5 Materials for skull base reconstruction should be selected based on the location and size of the defects, and the etiology of CSF leak.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endonasal Reconstruction Using a Pedicled Middle Turbinate Flap for Spontaneous Cerebrospinal Fluid Rhinorrhea

Takahara

Ueda

Toda

2021

Journal of Craniofacial Surgery

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However, the postoperative reconstruction for such large defect including TMJ component is a very difficult challenge.For TMJ reconstruction, 2 main options are available: alloplastic condylar prosthesis and autologous tissue transfer. Alloplastic TMJ prosthesis is considered the clinical standard. 5 However, this alloplastic joint replacement is widely used, although only by few surgeons who perform TMJ reconstruction. 6 To prevent prosthesis penetrate the cranial fossa, a combined use of stock prosthesis is necessary. However, this TMJ-stock prosthesis needs elaborate adaptation, which is difficult to achieve after cancer radical surgery. For large, challenging defects, the commercial TMJ prosthesis cannot restore mandible continuity. In comparison with our method, the commercial TMJ prosthesis is very expensive.The autologous bone graft is another option for TMJ reconstruction, such as ribs and the free fibular flap. Costochondral rib graft is the gold standard in children due to growth potential from the cartilage, although it is unpredictable. Moreover, joint ankylosis and a decrease in joint function are complications. Besides, costochondral graft is not resistant to postoperative radiotherapy after advanced oral cancer operation. Vascularized bone graft, such as fibular flap, is another option with acceptable long-term outcomes. 7 However, there are concern such as donor site morbidity and insufficient soft tissue volume to restore large defect like hemimandibulectomy. Furthermore, hypomobility, difficulty in achieving appropriate condylar position, and postoperative ankylosis also reported. 8 For our case, using fibular flap will need another ALT free flap to restore such a large soft tissue defect. It is a timeconsuming operation. Moreover, the possibility of postoperative ankylosis, joint hypomobility, osteonecrosis due to following radiotherapy is another concern. Therefore, we did not perform free fibular flap simultaneously.When alloplastic TMJ condyle is unavailable, a reconstruction plate is a candidate for temporal TMJ reconstruction. Shukla et al 9 first mentioned the use of a reconstruction plate to reconstruct the defect after hemimandibulectomy in cT2N1M0, stage III retromolar trigone squamous cell carcinoma. However, Shukla did not show a clinical picture of his case. Hocaoglu et al 10 presented a case of ameloblastoma treated with segmental mandibulectomy and reconstruction by using a reconstruction plate-bended artificial condyle. His method is similar to ours, but he connected the condylar head and reconstruction plate with wire and screws. However, the author did not mention how he fixed the condylar head to the fossa. Back to our case, we present a well document case with details using this method for the defect of hemimandibulectomy. Such large defect is unable to restore by alloplastic TMJ prosthesis. Free fibular flap is most widely used for such cases. However, postoperative CCRT usually leads to poor healing of the bone, even osteoradionecrosis of the fibular. In such circumstance, ...

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“…For TMJ reconstruction, 2 main options are available: alloplastic condylar prosthesis and autologous tissue transfer. Alloplastic TMJ prosthesis is considered the clinical standard 5 . However, this alloplastic joint replacement is widely used, although only by few surgeons who perform TMJ reconstruction 6 .…”

Section: Discussionmentioning

confidence: 99%

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mentioning

confidence: 99%

Clinical T4b Squamous Cell Carcinoma Resection With Hemimandibulectomy and Temporomandibular Joint Reconstruction With Bridging Plate and Modified Dautrey Procedure

Shih

Lee²,

Lin

2021

Journal of Craniofacial Surgery

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beam CT-based radiographic measurements were the most accurate method for determining the working length, followed by electronic apex locators, which had very close results to cone-beam CT. 5 One of the disadvantages of Ca(OH) 2 is that when it comes in contact with pulp proteins, the bactericidal activity quickly weakens due to the oxidation reaction. Recently, copper-calcium hydroxide has been widely available for its potent antimicrobial properties and superior regenerative attributes. According to a recent study, the copper-calcium hydroxide and electrophoresis technique is more effective in treating destructive periodontitis up to 8 months compared to that of traditional method. 6 Another alternative biomaterial in endodontics is mineral trioxide aggregate, which showed highly excellent biocompatibility and stability over time. 7 The treating dentist should be aware of the advantages and the disadvantages of the current biomaterials in market, and make the appropriate of choice of treatment based on each individual patients.Unfortunately, dental practitioner negligence, which jeopardizes the required standards of healthcare, fails to prevent this potentially life-changing injury, as seen in the current case. In dental practice, an injury resulting from lack of care can be considered negligence. In the current literature, there are no official representative article concerning the potential hazards of root canal filling material extrusion into the IAN, and its legal justice for urgent management.In this current case report, the ethnical responsibilities of the clinician were not upheld due to failure to assess the osteomyelitic lesion before treatment, lack of appropriate clinician-patient communication and trust, lack of clinician experience, and failure to identify the dental negligence that ultimately caused the IAN injury. In the event of malpractice, the professional liability of the dentist must be established. As a lifeguard of human health, dentists have the legal and ethical obligations to perform the optimal treatment procedure in accordance with the ethical mission. Though law is universal and applicable to all fields of medicine, including dentistry, ethics and morals can differ by individual. Because of this, a minimum threshold of ethics must be established by law. CONCLUSIONSIn the current corporate environment of dentistry within a highly developing market system governed by profit and loss concerns, one should never forget the main goal of medicine, which is to not harm.

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Temporomandibular joint reconstruction

Cited by 17 publications

References 58 publications

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis—Review of the Literature

Endoscopic Endonasal Reconstruction Using a Pedicled Middle Turbinate Flap for Spontaneous Cerebrospinal Fluid Rhinorrhea

Clinical T4b Squamous Cell Carcinoma Resection With Hemimandibulectomy and Temporomandibular Joint Reconstruction With Bridging Plate and Modified Dautrey Procedure

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