Abstract
The aim of this study was to quantitatively evaluate alloplastic Temporomandibular Joint (TMJ) Prostheses against other treatment modalities regarding the jaw kinematics. Six patients with Temporomandibular Joint Prostheses, four with mandibular ramus Patient-Specific Implant (PSI) with condylar head preservation, and four after mandibular condylectomy were evaluated by the means of axiography (Cadiax Compact 2), which is the noninvasive three-dimensional study of condylar movements. The patients were also evaluated clinically for the mandibular movements. The study revealed that the significant movement limitations occurred bilaterally in patients fitted with TMJ prosthesis. For the protrusion movement, the vector length of the movement (L) for the TMJ prosthesis was 0.31 vs. 3.01 mm for the PSI (Kruskal–Wallis chi-squared = 9.1667, df = 2, p-value = 0.01022, post hoc Dunn p-value = 0.015) and for the laterotrusion to the operated side, the length of the vector (L) was 0.66 vs. 3.35 mm, respectively. Statistically significant differences between groups were most frequent for the laterotrusion to the unoperated side. The study shows that a further development on TMJ Prostheses geometry and materials is needed.
Highlights
In the United States, 572 Temporomandibular Joint (TMJ) Prostheses were fitted in2014, and one of the leading manufacturers (TMJ Concepts) produced 1004 devices
Group B: in which the resection was performed with the preservation of the condylar head and the reconstruction was made with titanium (Ti6Al4V) Patient-Specific Implant (PSI)
TMJ Concepts device was used, while in the Mommaerts et al study, the PSIs were used. These results show that to obtain the best possible range of motion, which provides the proper stomatognathic system performance, it is important to preserve the attachment and function of Lateral Pterygoid Muscle (LPM) and to obtain the proper position and geometry of the TMJ
Summary
In the United States, 572 Temporomandibular Joint (TMJ) Prostheses were fitted in. 2014, and one of the leading manufacturers (TMJ Concepts) produced 1004 devices. It is estimated that in 2030 those numbers will reach 902 and 1658, respectively [1]. There are two FDA-approved alloplastic TMJ Total Joint Replacement (TJR) systems—these are TMJ Concepts and Zimmer Biomet. Woo-Young et al compared the complication rate and patients Quality of Life (QoL) of costochondral rib graft versus alloplastic TMJ TJR. Seven papers were qualified, comprising 180 patients with costochondral grafts and 6 papers comprising 275 patients with alloplastic TMJ TJR. The success rate was 61% and 95%, respectively [3]. The development of TMJ TJR systems seems legit
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