China Journal of Oral and Maxillofacial Surgery ›› 2017, Vol. 15 ›› Issue (1): 20-25.doi: 10.19438/j.cjoms.2017.01.005

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Effect of total joint TMJ prosthesis in the treatment of temporomandibular joint ankylosis

HE Dong-mei, HU Yi-hui, YANG Chi, CHEN Min-jie, ZHANG Shan-yong, LI Hui, BAI Guo, ZHANG Lu-zhu, LU Chuan, HUANG Dong   

  1. Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China
  • Online:2017-01-20 Published:2017-02-27

Abstract: PURPOSE: The aim of the study was to apply and evaluate the effect of total TMJ prosthesis in the treatment of temporomandibular joint(TMJ) ankylosis. METHODS: Patients treated from 2013 to 2015 were reviewed. Computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Free fat harvested from the mandibular incision subcutaneously was grafted around the artificial condylar head to prevent ectopic bone formation. For cases with severe mandibular deficiency, the mandibular ramus was elongated by the prosthesis and combined with Le Fort I osteotomy under the guide of digital occlusal splint. At least 1 year follow-up was completed after operation to evaluate mouth opening, occlusal stability, bone resorption around screws and ectopic bone formation around artifical condylar head. RESULTS: Eleven patients with 15 joints were included. In 4 patients with severe mandibular deficiencies, their mandibular ramus was elongated by TMJ prostheses combined with Le Fort I osteotomy guided by digital templates. There was no prosthesis loosening, breakage, or infection leading to removal during a mean follow-up period of 22.9 months (12-31 months) after operation. Mouth opening was significantly improved from 5.5 mm preoperatively to 31.5 mm postoperatively (P<0.05). No ectopic bone formation was found around the artificial condyles, and no bone resorption was detected around the screws on CT scans. CONCLUSIONS: TMJ prosthesis is a reliable treatment option for ankylosis, especially in recurrent cases. It can correct jaw bone deformities simultaneously with stable results.

Key words: Total TMJ prosthesis, Temporomandibular joint ankylosis, Effect analysis

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