Tomographic evaluation of temporomandibular joints following discoplasty or placement of polytetrafluoroethylene implants

Florine, Brent L.; Gatto, Daniel J.; Wade, Marshall; Waite, Daniel E.

doi:10.1016/0278-2391(88)90080-8

Cited by 39 publications

(3 citation statements)

References 24 publications

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“…More information about the biomechanical properties of the disc is also required for the design of TMJ implants. Some of the available implant materials failed under functional conditions (Silastic- Dolwick and Aufdemorte, 1985;Eriksson and Westesson, 1986;Westesson et al, 1987;Sanders et al, 1990;Tucker and Watzke, 1991;Proplast-Heffez et al, 1987;Florine et al, 1988;Valentine et al, 1989;Wagner and Mosby, 1990). The major reason for these failures is that these biomaterials were not strong enough to withstand the functional loading applied to them.…”

Section: (V) Concluding Remarksmentioning

confidence: 99%

Biomechanical Behavior of the Temporomandibular Joint Disc

Tanaka

Eijden

2003

Critical Reviews in Oral Biology & Medicine

193

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The temporomandibular joint (TMJ) disc consists mainly of collagen fibers and proteoglycans constrained in the interstices of the collagen fiber mesh. This construction results in a viscoelastic response of the disc to loading and enables the disc to play an important role as a stress absorber during function. The viscoelastic properties depend on the direction (tension, compression, and shear) and the type of the applied loading (static and dynamic). The compressive elastic modulus of the disc is smaller than its tensile one because the elasticity of the disc is more dependent on the collagen fibers than on the proteoglycans. When dynamic loading occurs, the disc is likely to behave less stiffly than under static loading because of the difference of fluid flow through and out of the disc during loading. In addition, the mechanical properties change as a result of various intrinsic and extrinsic factors in life such as aging, trauma, and pathology. Information about the viscoelastic behavior of the disc is required for its function to be understood and, for instance, for a suitable TMJ replacement device to be constructed. In this review, the biomechanical behavior of the disc in response to different loading conditions is discussed.

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Section: (V) Concluding Remarksmentioning

confidence: 99%

Biomechanical Behavior of the Temporomandibular Joint Disc

Tanaka

Eijden

2003

Critical Reviews in Oral Biology & Medicine

193

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“…While a majority of the discectomy studies that used imaging as an assessment focused on discectomy without graft replacement, synthetic graft replacements, such as silicone sheets (Schliephake et al, 1999), have been used and resulted in little improvement in joint function following surgery. Polytetrafluoroethylene disc replacements resulted in severe radiographic changes in the joint as well as foreign body giant cell reaction (Florine et al, 1988). The use of Proplast Teflon interpositional implants also resulted in symptomatic joints with condylar resorption (Spagnoli and Kent, 1992) as well as implant migration and fragmentation accompanied by severe condylar, glenoid fossa, and eminence remodeling changes (Heffez et al, 1987).…”

Section: Discectomy and Graftmentioning

confidence: 99%

TMJ Disc Removal

Hagandora

Almarza

2012

J Dent Res

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The debate continues surrounding the use of disc removal (discectomy) as the primary surgical treatment for patients suffering from severe temporomandibular joint disorders. Furthermore, the effectiveness of pre-clinical animal models for predicting the response of the joint to discectomy in humans remains uncertain. This review compares the results of animal models with the most recent clinical findings while also focusing on investigations that use imaging as an assessment tool. After a review of the literature from well-established animal studies to clinical findings, it was found that the results of animal models for discectomy corresponded to the clinical findings seen in patients. Overall, there is adaptive remodeling or degeneration of the TMJ following discectomy. Additionally, there is some reduction in pain but with various amounts of dysfunction remaining following disc removal. Noteworthy, in the most recent clinical studies, imaging was not used as an outcome to assess the success of discectomy at preventing further joint degeneration.

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“…E nd-stage degeneration and destruction of the temporomandibular joint (TMJ) can occur as a result of trauma, osteoarthritis, reactive arthritis, failed previous surgeries, infection, ankylosis, idiopathic condylar resorption, connective tissue/autoimmune diseases (CTAD; e.g., rheumatoid arthritis, psoriatic arthritis, lupus, scleroderma, Sjogren's disease, ankylosing spondylitis), and other pathological TMJ conditions. The joint structures also can be destroyed from alloplastic implants such as Proplast-Teflon (Vitek Inc, Houston, TX), Silastic (Dow-Corning Inc, Midland, MO), acrylic, and bone cements (1)(2)(3)(4). These TMJ pathologies can result in retrusion of the mandible, loss of vertical height of the ramus secondary to condylar resorption, anterior open bite, Class II malocclusion, increased occlusal and mandibular plane angulations, limited jaw function, masticatory dysfunction, alteration of speech, decreased oropharyngeal airway, sleep apnea, and mild, moderate, or severe pain.…”

mentioning

confidence: 99%

Outcomes of Treatment with Custom-Made Temporomandibular Joint Total Joint Prostheses and Maxillomandibular Counter-Clockwise Rotation

Wolford¹,

Pinto²,

Cárdenas³

et al. 2008

Baylor University Medical Center Proceedings

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The first 25 consecutive patients with high occlusal plane angulation, dysfunction, and pain who were treated with temporomandibular joint (TMJ) total joint prostheses and simultaneous maxillomandibular counterclockwise rotation were evaluated before surgery (T1), immediately after surgery (T2), and at the longest follow-up (T3) for surgical movements and long-term stability. Subjective ratings were used for patients' facial pain/headache, TMJ pain, jaw function, diet, and disability, and objective functional changes were determined by measuring maximum incisal opening and lateral excursive movements. Results showed that the areas of greatest surgical change included an average decrease in the occlusal plane of 13.3 degrees with advancement at point B of 13.4 mm and at the genial tubercles of 16.3 mm. At longest follow-up, relapse was 0.7 degrees, 0.8 mm, and 1.2 mm, respectively, with no statistically significant changes. Significant subjective pain and dysfunction improvements were observed (P ≤ 0.001). Maximum incisal opening increased, but lateral excursion decreased. Those who had two or more previous TMJ surgeries showed greater levels of dysfunction at T1 and T3 than those who had one or no previous surgeries, but otherwise patients presented similar amounts of absolute changes. In conclusion, end-stage TMJ patients can achieve significant improvement in their pain, dysfunction, dentofacial deformity, and airway problems in one operation with TMJ reconstruction and mandibular advancement using TMJ custom-made total joint prostheses and simultaneous maxillary osteotomies for maxillomandibular counter-clockwise rotation.

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Tomographic evaluation of temporomandibular joints following discoplasty or placement of polytetrafluoroethylene implants

Cited by 39 publications

References 24 publications

Biomechanical Behavior of the Temporomandibular Joint Disc

Biomechanical Behavior of the Temporomandibular Joint Disc

TMJ Disc Removal

Outcomes of Treatment with Custom-Made Temporomandibular Joint Total Joint Prostheses and Maxillomandibular Counter-Clockwise Rotation

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