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

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.

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Temporomandibular Joint (TMJ) Ankylosis Resection to Total Joint replacement – 30 Years Journey

Journal of the Bahrain Medical Society ◽

10.26715/jbms.33_2021_2_9 ◽

2021 ◽

Vol 33 (2) ◽

Keyword(s):

Temporomandibular Joint ◽

Joint Replacement ◽

Total Joint Replacement ◽

Articular Surface ◽

Mandibular Condyle ◽

Mouth Opening ◽

Patient Specific ◽

Mandibular Fractures ◽

Tmj Ankylosis ◽

Condyle Fracture

Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disc–condyle complex to the temporal articular surface that confines the mandibular drive, including the fibrous adhesions/ bony fusion between condyle, disc, glenoid fossa, and eminence. It is a severe and incapacitating ailment that can cause mastication, digestion, speech, appearance, and hygiene concerns. This is an unusual case of a 42-year-old adult patient, who suffered from bilateral recurrent TMJ ankylosis and reported following trauma to the face. The patient had a history of mandibular condyle fracture at ten years of age. Excision of existing ankylotic mass followed by reconstruction with patient-specific total joint replacement (TJR) was carried out. Postoperative physiotherapy exercises in the presented case improved patient’s mouth opening, and mandibular movement. Patient-specific TJR procedures and postoperative physiotherapy will be helpful in cases with TMJ ankylosis. Keywords: Genioplasty; Mandibular Condyle; Mandibular fractures; Temporomandibular Ankylosis; Temporomandibular Joint

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Alterations of mandibular movement patterns after total joint replacement: a case series of long-term outcomes in patients with total alloplastic temporomandibular joint reconstructions

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2018.06.005 ◽

2019 ◽

Vol 48 (2) ◽

pp. 225-232 ◽

Cited By ~ 5

Author(s):

A. Wojczyńska ◽

L.M. Gallo ◽

M. Bredell ◽

C.S. Leiggener

Keyword(s):

Temporomandibular Joint ◽

Joint Replacement ◽

Total Joint Replacement ◽

Case Series ◽

Movement Patterns ◽

Mandibular Movement ◽

Long Term Outcomes

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The Value of SPECT CT in Patient Management of Osteoarthritis of the Temporomandibular Joint

Journal of Dental and Maxillofacial Surgery ◽

10.18314/jdms.v1i1.1053 ◽

2018 ◽

Vol 1 (1) ◽

pp. 18-22

Author(s):

Bernard Bonte ◽

Kristoff Muylle ◽

Nigel Shaun Matthews

Keyword(s):

Temporomandibular Joint ◽

Total Joint Replacement ◽

Mouth Opening ◽

Stage Iv ◽

Stage Disease ◽

Diagnostic Arthroscopy ◽

Custom Made ◽

The Right ◽

End Stage ◽

Masseter Muscles

A 30 year old female patient presented in 2009 with severe bilateral temporomandibular joint (TMJ) pain, restricted mouth opening and tenderness over the masseter muscles. She was initially diagnosed with Wilkes Stage IV of the right and left TMJ. A diagnostic arthroscopy performed bilaterally failed to releave her pain. She was diagnosed with an isolated spondyloarthropathy of TMJ based on a positive test for HLA B. Further medicamentous treatment was unsuccesfull over subsequent months and years. CBCT of the TMJ showed discrete sclerosis of the right TMJ. Based on an additional SPECT-CT with 99 Tcm hydroxymetylene diphosphonate with significant increased uptake of the tracer in the right TMJ, the right TMJ was considered as end stage disease and a right total joint replacement (TJR) using a Zimmer Biomet custom made prosthesis was performed. A left TJR was performed 3 years.

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