Abstract
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.
Highlights
The temporomandibular joint (TMJ) often loses its function due to various causes
The costochondral graft is popular as a conventional TMJ total joint replacement (TJR) procedure, which is standard in young patients [3,4,5,6]
The glenoid fossa component is formulated with ultra-high molecular weight polyethylene and the ramus condylar component is constructed from a cobalt-chromium-molybdenum alloy
Summary
The temporomandibular joint (TMJ) often loses its function due to various causes. In severe and non-salvageable cases, it often needs total joint replacement (TJR). The use of alloplastic materials for TMJ TJR was avoided due to various foreign body reactions to the Vitek or Kent prostheses [12]. To overcome these problems, progressive approaches, such as the TMJ Concepts system and the Biomet Lorenz system, were developed and approved for TJR of TMJ by the Food and Drug Administration (FDA) in the United States. The Korean Ministry of Drug and Safety approved the use of the Biomet Lorenz system for TMJ TJR. To date, this is the only approved system for TMJ TJR in Korea [13]. The glenoid fossa component is fixed into the bony glenoid fossa with several positional titanium screws
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