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Oh HJ, Yoon HJ, Huh KH, Kim B, Kwon IJ, Kim SM, Park JY, Choi SW, Lee JH. Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review. World J Surg Oncol 2023; 21:253. [PMID: 37596637 PMCID: PMC10439660 DOI: 10.1186/s12957-023-03143-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ. METHODS Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed. RESULTS The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%). CONCLUSIONS For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.
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Affiliation(s)
- Hyun Jun Oh
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Bongju Kim
- Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea
| | - Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Joo Yong Park
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Sung Weon Choi
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Jong-Ho Lee
- Oral Oncology Clinic, National Cancer Center, Goyang, Korea.
- Dental Life Science Research Institute, Innovation Research & Support Center for Dental Science, Seoul National University Dental Hospital, Seoul, Korea.
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Subash P, Nerurkar SA, Krishnadas A, Vinay V, Iyer S, Manju V. Patient Specific Alloplastic Implant Reconstruction of Mandibular Defects-Safe Practice Recommendations and Guidelines. J Maxillofac Oral Surg 2023; 22:28-36. [PMID: 37041956 PMCID: PMC10082692 DOI: 10.1007/s12663-023-01881-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/21/2023] [Indexed: 03/29/2023] Open
Abstract
Mandibular continuity defects are commonly seen after tumor resection, osteomyelitis or maxillofacial trauma. Three-dimensional reconstruction of these mandibular segmental defects is critical for proper mandibular functioning and esthetics. Various methods used to reconstruct such defects include bridging reconstruction plates, modular endoprosthesis, non-vascularized and vascularized bone grafting with stock reconstruction plate or patient specific implants (PSI) and tissue engineering bone transfer. But in the recent years, literature documents use of PSI only alloplastic reconstruction as an alternate to microvascular bone flap reconstruction. Representative cases enumerate current practice of 'patient specific implant only' mandibular reconstruction and its pitfalls. This article discusses current status of literature on PSI's, choice of indications for 'PSI only' mandibular reconstruction and also proposes guidelines for safe practice of patient specific implant reconstruction of mandible.
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Affiliation(s)
- Pramod Subash
- Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
| | - Shibani A. Nerurkar
- Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
| | - Arjun Krishnadas
- Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
| | - Vinanthi Vinay
- Department of Cleft and Craniomaxillofacial Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
| | - Subramania Iyer
- Department of Head and Neck Surgery, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
| | - V. Manju
- Department of Prosthodontics and Implantology, Amrita Institute of Medical Sciences, Kochi, Kerala 41 India
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Zoabi A, Redenski I, Oren D, Kasem A, Zigron A, Daoud S, Moskovich L, Kablan F, Srouji S. 3D Printing and Virtual Surgical Planning in Oral and Maxillofacial Surgery. J Clin Med 2022; 11:jcm11092385. [PMID: 35566511 PMCID: PMC9104292 DOI: 10.3390/jcm11092385] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
Compared to traditional manufacturing methods, additive manufacturing and 3D printing stand out in their ability to rapidly fabricate complex structures and precise geometries. The growing need for products with different designs, purposes and materials led to the development of 3D printing, serving as a driving force for the 4th industrial revolution and digitization of manufacturing. 3D printing has had a global impact on healthcare, with patient-customized implants now replacing generic implantable medical devices. This revolution has had a particularly significant impact on oral and maxillofacial surgery, where surgeons rely on precision medicine in everyday practice. Trauma, orthognathic surgery and total joint replacement therapy represent several examples of treatments improved by 3D technologies. The widespread and rapid implementation of 3D technologies in clinical settings has led to the development of point-of-care treatment facilities with in-house infrastructure, enabling surgical teams to participate in the 3D design and manufacturing of devices. 3D technologies have had a tremendous impact on clinical outcomes and on the way clinicians approach treatment planning. The current review offers our perspective on the implementation of 3D-based technologies in the field of oral and maxillofacial surgery, while indicating major clinical applications. Moreover, the current report outlines the 3D printing point-of-care concept in the field of oral and maxillofacial surgery.
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Affiliation(s)
- Adeeb Zoabi
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Idan Redenski
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Daniel Oren
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Adi Kasem
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Asaf Zigron
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Shadi Daoud
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Liad Moskovich
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Fares Kablan
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Samer Srouji
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
- Correspondence:
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Accuracy of Guided Surgery and Real-Time Navigation in Temporomandibular Joint Replacement Surgery. Dent J (Basel) 2021; 9:dj9080087. [PMID: 34435999 PMCID: PMC8394290 DOI: 10.3390/dj9080087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Sophisticated guided surgery has not been implemented into total joint replacement-surgery (TJR) of the temporomandibular joint (TMJ) so far. Design and in-house manufacturing of a new advanced drilling guide with vector and length control for a typical TJR fossa component are described in this in vitro study, and its accuracy/utilization was evaluated and compared with those of intraoperative real-time navigation and already available standard drilling guides. Methods: Skull base segmentations of five CT-datasets from different patients were used to design drilling guides with vector and length control according to virtual surgical planning (VSP) for the TJR of the TMJ. Stereolithographic models of the skull bases were printed three times for each case. Three groups were formed to compare our newly designed advanced drilling guide with a standard drilling guide and drill-tracking by real-time navigation. The deviation of screw head position, screw length and vector in the lateral skull base have been evaluated (n = 72). Results: There was no difference in the screw head position between all three groups. The deviation of vector and length was significantly lower with the use of the advanced drilling guide compared with standard guide and navigation. However, no benefit in terms of accuracy on the lateral skull base by the use of real-time navigation could be observed. Conclusion: Since guided surgery is standard in implant dentistry and other CMF reconstructions, this new approach can be introduced into clinical practice soon, in order to increase accuracy and patient safety.
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Kumar S, Khanna V, Singh BP, Mehrotra D, Patil RK. Impact of technology in temporomandibular joint reconstruction surgeries: A systematic review. J Plast Reconstr Aesthet Surg 2021; 74:1331-1345. [PMID: 33597084 DOI: 10.1016/j.bjps.2020.12.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/20/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The digital technologies, in recent years, have integrated with temporomandibular joint reconstruction surgeries (TRS). Therefore, a systematic study was conducted to assess the impact of digital technologies in TRS. Besides, a brief comparison between the CAD/CAM and 3D printing (3DP) technologies is presented. MATERIALS & METHODS We searched in PubMed, ProQuest and Science direct using PRISMA guidelines. Population = Patients undergoing TRS, Intervention=CAD/CAM or 3DP, Comparison= conventional TRS (cTRS) vs technology integrated TRS (tiTRS), Outcome= Advantages/disadvantages of technology and Subjective/objective symptoms, Study design= Type of study. The quality of observational study was assessed using ROBINS-1 Assessment tool. RESULTS Out of 632 articles, 30 articles for CAD/CAM and 3DP were included in the study. A majority of TRS were done for ankylosis (new or re-entry), earlier failed surgery, osteoarthritis and neoplastic cases. The articles were divided into two groups. Group I: CAD/CAM(n = 16), Group II: 3DP (n = 14). DISCUSSION tiTRS had definite advantages over cTRS with lesser surgery time, defined osteotomies, précised implant fitting and better final result outcome however, evidence for tiTRS in long-term follow-up is inconclusive. The cost, time, infrastructure and ethical/regulatory issues are the downsides of assisted surgeries. It was observed that 3DP technology is versatile and its adaptation in the fabrication of customized implants has outpaced CAD/CAM technology. However, literature data is feeble qualitatively and quantitatively. CONCLUSION The TRS has leveraged the flexibility and precision of assisted surgeries. In future, tiTRS could successfully replace cTRS, provided that shortcomings should be dealt so that the technology can benefit the masses.
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Affiliation(s)
- Sumit Kumar
- Department of Health Research-Multi Disciplinary Unit, King Georges Medical University, Lucknow, India-226003
| | - Vikram Khanna
- Department of Oral Medicine & Radiology, King Georges Medical University, Lucknow, India-226003.
| | - Balendra P Singh
- Department of Prosthodontics King Georges Medical University Lucknow-226003, India
| | - Divya Mehrotra
- Department of Oral & Maxillofacial Surgery, King Georges Medical University Lucknow-226003, India
| | - Ranjit K Patil
- Department of Oral Medicine & Radiology, King Georges Medical University, Lucknow, India-226003
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Saussier L, Choplin M, Le Toux G. Current indications of mandibular condyle plate osteosynthesis: two cases reports. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Certain benign or malignant pathologies may require a mandibulectomy with resection of the condyle. The gold standard for this type of reconstruction is the microanastomosed fibular free flap. An immediate reconstruction technique using an osteosynthesis plate with condyle can be proposed. The aim of this article is to evaluate the indications and describe the complications of osteosynthesis plates with condyle, through the presentation of two clinical cases. Observation: Two patients were treated by radical hemi-mandibulectomy, with cervical curage, placement of an osteosynthesis plate with condyle, and coverage with flap of pectoralis major. Then they received radiation therapy with or without chemotherapy. No cases of erosion of the glenoid fossa or tympanal bone were found. Comments: Condyle osteosynthesis plates are an interesting alternative when a fibular flap cannot be performed for local (arteriopathy), carcinologic (poor prognosis), or general and anesthesic reasons. A tissue preservation protocol, with conformation and coverage of the plate must be undertaken to limit the risk of complications (infections, exposure and fracture of the plate, temporal bone erosion, heterotopic bone formations). Conclusion: Condyle osteosynthesis plates restore aesthetic and function immediately, temporarily or even permanently. Clinical and radiological follow-up must be established following this type of reconstruction.
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Brown ZL, Sarrami S, Perez DE. Will they fit? Determinants of the adaptability of stock TMJ prostheses where custom TMJ prostheses were utilized. Int J Oral Maxillofac Surg 2020; 50:220-226. [PMID: 32591225 DOI: 10.1016/j.ijom.2020.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
Currently only two alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) systems are available in the United States. The aim of this study was to define variables that determine whether a Biomet stock prosthesis could have been used to reconstruct a TMJ previously reconstructed with a TMJ Concepts patient-fitted prosthesis. All of the TMJ Concepts prostheses placed between 2010 and 2018 at the University of Texas - Health at San Antonio were analyzed retrospectively. There were 128 cases (241 joints) with intact stereolithographic models analyzed for successful adaptation of the Biomet stock TMJ prosthesis. Anatomical, demographic, etiological, and perioperative data were gathered for each joint to investigate possible causes of failure of stock adaptation. The majority of joints, 74% (178/241), could have had a stock prosthesis adapt. All joints with ≥40mm gap arthroplasty failed stock prosthesis adaptation. Only 50% (32/64) of the joints with at least one previous open TMJ surgery and 60% (58/96) of the joints with concomitant orthognathic surgery could have had a stock TMJ prosthesis. The stock prosthesis could not be adapted for any of the patients requiring TMJ replacement for congenital disorders or those requiring TMJ salvage. Overall, the majority of cases treated with a patient-specific TMJ TJR could have been treated with a stock prosthesis.
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Affiliation(s)
- Z L Brown
- Department of Oral and Maxillofacial Surgery, University of Texas - Health at San Antonio, San Antonio, Texas, USA
| | - S Sarrami
- Department of Oral and Maxillofacial Surgery, University of Texas - Health at San Antonio, San Antonio, Texas, USA
| | - D E Perez
- Department of Oral and Maxillofacial Surgery, University of Texas - Health at San Antonio, San Antonio, Texas, USA.
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Yoda T, Ogi N, Yoshitake H, Kawakami T, Takagi R, Murakami K, Yuasa H, Kondoh T, Tei K, Kurita K. Clinical guidelines for total temporomandibular joint replacement. JAPANESE DENTAL SCIENCE REVIEW 2020; 56:77-83. [PMID: 32612715 PMCID: PMC7310689 DOI: 10.1016/j.jdsr.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Total joint replacement (TJR) of the temporomandibular joint (TMJ) is a promising surgical procedure and device for treating end-stage diseases of the TMJ. For the functional and aesthetic reconstruction of the oral and maxillofacial head and neck region, TMJ TJR significantly helps maintain the patient's quality of life in terms of a better diet, mastication, speech and social interaction. TMJ TJR was approved by regulatory authorities in 2019 in Japan, thus enabling the clinical application of the TJR system. However, the surgery demands particularly difficult and high-risk procedures, necessitating the prudent selection of indicated patients. The joint committee of the Japanese Society of Oral and Maxillofacial Surgeons and Japanese Society for Temporomandibular Joint is working together to develop an appropriate clinical guideline for TMJ TJR.
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Affiliation(s)
- Tetsuya Yoda
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Nobumi Ogi
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Japan
| | - Hiroyuki Yoshitake
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tetsuji Kawakami
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan
| | - Ritsuo Takagi
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Division of Oral and Maxillofacial Surgery, Niigata University, Graduate School of Medical and Dental Sciences, Japan
| | - Kenichiro Murakami
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, Ako City Hospital, Japan
| | - Hidemichi Yuasa
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, National Hospital Organization Toyohashi Medical Center, Japan
| | - Toshirou Kondoh
- Department of Maxillofacial Surgery, Nihon University School of Dentistry at Matsudo, Japan
| | - Kanchu Tei
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine and Graduate, School of Dental Medicine, Hokkaido University, Japan
| | - Kenichi Kurita
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Japan
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Sembronio S, Tel A, Robiony M. Comment on: “Does Accurate Positioning of the Temporomandibular Joint Titanium Condylar Prosthesis Prevent Complications?”. J Oral Maxillofac Surg 2019; 77:888-889. [DOI: 10.1016/j.joms.2018.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022]
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Goodson AM, Kittur MA, Evans PL, Williams EM. Patient-specific, printed titanium implants for reconstruction of mandibular continuity defects: A systematic review of the evidence. J Craniomaxillofac Surg 2019; 47:968-976. [PMID: 30885527 DOI: 10.1016/j.jcms.2019.02.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/04/2019] [Accepted: 02/26/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- Alexander Mc Goodson
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 1DL, United Kingdom
| | - Madhav A Kittur
- Morriston Hospital, Heol Maes Eglwys, Swansea, SA6 6NL, United Kingdom
| | - Peter L Evans
- Morriston Hospital, Heol Maes Eglwys, Swansea, SA6 6NL, United Kingdom
| | - E Mark Williams
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, CF37 1DL, United Kingdom.
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De Meurechy N, Braem A, Mommaerts M. Biomaterials in temporomandibular joint replacement: current status and future perspectives—a narrative review. Int J Oral Maxillofac Surg 2018; 47:518-533. [DOI: 10.1016/j.ijom.2017.10.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/09/2017] [Accepted: 10/02/2017] [Indexed: 12/31/2022]
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Abstract
PURPOSE OF REVIEW Temporomandibular joint (TMJ) reconstruction represents one of the more challenging clinical problems that a head and neck surgeon encounters. Fortunately, the problem is fairly uncommon; however, at the same time, clear clinical guidelines have not been formulated. The goal of this review is to present the established solutions to this difficult reconstructive challenge and highlight key developments that have been recently published. RECENT FINDINGS Modern-day approaches to TMJ reconstruction include a handful of surgical modalities: costochondral grafting, revascularized tissue transfer, distraction osteogenesis, and alloplastic temporomandibular joint replacement (APTMJR). Over the past several years, publications have focused primarily on distraction osteogenesis and APTMJR. In particular, APTMJR is emerging as a highly successful and versatile surgical modality when faced with TMJ defects. SUMMARY With long-term follow-up after APTMJR approaching 20 years at several of the pioneering centers, alloplastic total joint replacement is emerging as the clinical standard when faced with TMJ defects in a variety of clinical situations. Unfortunately, the dogma of serious complications that occurred during early development may still be stalling widespread acceptance of APTMJR. Due to the complexity of the surgery, its relative infrequency and the lack of exposure in the majority of residency training programs, this surgery is currently best performed by tertiary referral centers.
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Moreira CVA, Serra AVP, Silva LOR, Fernandes ACF, de Azevedo RA. Total bilateral TMJ reconstruction for pain and dysfunction: Case report. Int J Surg Case Rep 2017; 42:138-144. [PMID: 29245099 PMCID: PMC5730393 DOI: 10.1016/j.ijscr.2017.11.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/17/2022] Open
Abstract
The use of TMJ protheses was configured as a good therapeutic alternative for severe conditions that do not respond to conservative treatments. A correct diagnosis of the pathology and the correct indication for reconstruction are fundamental for the success of the technique. The stock prostheses is a good alternative when there is no need for mandibular advancement and the branches are still preserved. Further studies are needed to demonstrate whether these results are long term.
Introduction Temporomandibular disorders encompass a set of clinical conditions that affect the temporomandibular joint, the masticatory muscles and the associated tissues. Many therapeutic alternatives can be considered, being divided into non-invasive, minimally invasive and invasive interventions. This work aims to report a case of inflammatory joint pain and dysfunction treated with bilateral TMJ full reconstruction with alloplastic prosthesis stock. Case report Patient D.J.S.S., female, 41 years old, hypertensive, for six years had constant pain in TMJ bilaterally, with limitation of mouth opening, with a clinical signs of joint disc displacement without reduction. Initially treated only by conservative approaches. Without improvement, arthrocentesis of the TMJ was performed. The symptoms do not regress, leading the patient to bilateral discopexy procedure. We opted for the alloplastic substitution of the temporomandibular joint with prostheses of stock in both joints through an established protocol. Discussion The main objective of the reconstruction of the temporomandibular joint in cases of joint bone degeneration is the restoration of form and function, considering the reduction of pain as a secondary result. Alloplastic replacement of TMJ can be considered as an alternative therapy to improve the quality of life of a small group of patients showing signs and symptoms of TMD as a reduction of maximum mouth opening, pain, etc. Conclusion The use of total joint prostheses has been configured as a good therapeutic alternative for severe conditions of TMJ that do not respond to conservative treatments. However, further studies are needed to demonstrate whether these results are long term.
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Farzad P. A Case of an Extensive Keratocystic Odontogenic Tumor in the Mandible Reconstructed with a Custom-Made Total Joint Prosthesis. Craniomaxillofac Trauma Reconstr 2017; 11:131-137. [PMID: 29892328 DOI: 10.1055/s-0036-1597585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022] Open
Abstract
The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has previously been reported to enhance the planning for the reconstruction of mandibular continuity defects and to reduce surgical time. Reported is a case of a large keratocystic odontogenic tumor (KOT) affecting right hemimandible including the condylar neck. This case was initially reconstructed with a condyle-bearing reconstruction plate, but because of fatigue fracture 15 years later, a new reconstruction with a custom-made total joint temporomandibular prosthesis was performed.
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Affiliation(s)
- Payam Farzad
- Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
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Aagaard E, Thygesen T. A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis. Int J Oral Maxillofac Surg 2014; 43:1229-35. [DOI: 10.1016/j.ijom.2014.05.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/19/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
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Schneider R, Burton R. Coordinated reconstruction with bilateral condylar replacement and dental implant rehabilitation: a clinical report. J Prosthet Dent 2013; 111:101-6. [PMID: 24189116 DOI: 10.1016/j.prosdent.2013.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The evaluation of complex facial-cranial trauma and subsequent restoration requires multidisciplinary treatment planning for optimal success and patient satisfaction. Patients with bilateral subcondylar fractures and facial-dental trauma are invariably challenging. Consideration of total joint replacement, along with the comprehensive evaluation of facial-dental esthetics and occlusion is critical for an optimal long-term outcome and for patient comfort. This patient treatment illustrates team cooperation and an optimal patient treatment outcome with long-term follow-up in the reconstruction of a complex cranial-facial injury from an unrestrained motor vehicle accident. The treatment included bilateral temporomandibular joint replacement with computer-aided design and computer-aided manufacturing fitted total temporomandibular joint reconstruction, grafting of a deficient anterior maxillary alveolar ridge, and dental implant placement and subsequent restoration with a partial fixed dental prosthesis.
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Affiliation(s)
- Robert Schneider
- Professor, Division Director Maxillofacial Prosthodontics, University of Iowa Hospitals and Clinics, Hospital Dentistry Institute, Iowa City, Iowa.
| | - Richard Burton
- Professor, Vice Chair, Oral and Maxillofacial Surgery, University of Iowa Hospitals and Clinics, Hospital Dentistry Institute, Iowa City, Iowa
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Briceño F, Ayala R, Delgado K, Piñango S. Evaluation of temporomandibular joint total replacement with alloplastic prosthesis: observational study of 27 patients. Craniomaxillofac Trauma Reconstr 2013; 6:171-8. [PMID: 24436755 DOI: 10.1055/s-0033-1343779] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 07/22/2012] [Indexed: 10/26/2022] Open
Abstract
Background Temporomandibular joint (TMJ) total replacement with alloplastic prostheses has been performed since 1960s. Research in these last two decades has achieved important improvement in the development of biomaterials, design, adaptation, and fixation of the prosthesis components. Objective To evaluate total TMJ replacement with alloplastic prostheses. Methods We studied 27 patients, between 19 and 73 years old, who had total TMJ uni- or bilateral replacement surgery with custom-made alloplastic prostheses manufactured by TMJ Concepts, Inc. (Ventura, CA) between 1996 and 2011. The general data and preoperative measurements were taken from medical records. Subjective data related to pain, diet consistency, and current quality of life were collected with a questionnaire answered by the patients; measures of maximum interincisal opening and lateral mandibular movements were obtained from direct examination. Results We found significant difference (p < 0.05) comparing pre- to postoperative results about improvement in mouth opening, pain relief, and satisfaction with the surgery and diet consistency. Conclusion The results of this study show that total alloplastic TMJ prostheses are an efficient, safe, and stable long-term solution for patients who need TMJ total replacement.
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Affiliation(s)
- Fernando Briceño
- Department of Maxillofacial Surgery, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Ronmell Ayala
- Department of Maxillofacial Surgery, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Karlina Delgado
- Department of Maxillofacial Surgery, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Sabrina Piñango
- Department of Maxillofacial Surgery, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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Areiza DA, Bonnet AS, Barbas A, Lipinski P. Measurement and interpretation of viscous interactions during contact between bone and prosthetic materials. Comput Methods Biomech Biomed Engin 2011. [DOI: 10.1080/10255842.2011.593754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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The use of TMJ Concepts prostheses to reconstruct patients with major temporomandibular joint and mandibular defects. Int J Oral Maxillofac Surg 2011; 40:487-96. [DOI: 10.1016/j.ijom.2010.12.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 11/12/2010] [Accepted: 12/21/2010] [Indexed: 11/17/2022]
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Hsu JT, Huang HL, Tsai MT, Fuh LJ, Tu MG. Effect of Screw Fixation on Temporomandibular Joint Condylar Prosthesis. J Oral Maxillofac Surg 2011; 69:1320-8. [DOI: 10.1016/j.joms.2010.05.074] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 05/04/2010] [Accepted: 05/21/2010] [Indexed: 11/29/2022]
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Lypka M, Urata M, Hammoudeh J. Delayed middle cranial fossa perforation after autologous temporomandibular joint reconstruction. J Oral Maxillofac Surg 2011; 69:1613-6. [PMID: 21367501 DOI: 10.1016/j.joms.2010.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 09/03/2010] [Accepted: 11/02/2010] [Indexed: 11/18/2022]
Affiliation(s)
- Michael Lypka
- Division of Pediatric Plastic and Craniofacial Surgery, University of Texas Medical School, Houston, TX 77030, USA.
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Replacement of the Condyle and Ascending Ramus by a Modular Endoprosthesis in Macaca fascicularis—Part 4: Evaluation of the Temporomandibular Joints. J Oral Maxillofac Surg 2010; 68:2136-45. [DOI: 10.1016/j.joms.2009.09.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 06/27/2009] [Accepted: 09/15/2009] [Indexed: 11/20/2022]
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Leiggener C, Jaquiéry C, Kunz C, Westermark A. Transparotid approach for tumor excision from the infratemporal space in temporomandibular joint reconstruction: a 3-year follow-up. ACTA ACUST UNITED AC 2010; 109:e1-4. [DOI: 10.1016/j.tripleo.2009.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 08/01/2009] [Accepted: 08/11/2009] [Indexed: 10/20/2022]
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Bayat M, Badri A, Moharamnejad N. Treatment of temporomandibular joint ankylosis: gap and interpositional arthroplasty with temporalis muscle flap. Oral Maxillofac Surg 2009; 13:207-212. [PMID: 19806372 DOI: 10.1007/s10006-009-0174-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE The purpose of this study was to examine the effectiveness of gap and interpositional arthroplasty with temporalis muscle flap in the treatment of the temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS This retrospective study was evaluated on 34 patients who were treated from February 2003 to July 2007. Diagnosis of TMJ ankylosis was based upon the clinical examination and plain radiography and CT scan. Eight patients (23.5%) had bilateral TMJ ankylosis, and four patients had reankylosis (that had been operated in another center). Trauma was the most etiological factor (88.2%) and osteochondroma of the condyle in one patient caused ankylosis. RESULTS Means of maximum mouth opening before and after operation were 5.00 (SD) 3.45 mm and 32.85 (SD) 5.51 mm, respectively. Reankylosis in two patients (5.9%) and facial nerve dysfunction in 12 surgery sides (28.5%) were noted. CONCLUSION The findings of this study suggest that the gap arthroplasty with temporalis muscle flap as interpositional graft is an effective method in the treatment of TMJ ankylosis. The osteoarthrectomy of the callus to create at least 10 mm gap and enough bulk of temporalis muscle flap as interpositional graft followed by at least a 6-month physiotherapy which play an important role in prevention of reankylosis.
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Affiliation(s)
- Mohammad Bayat
- Department of Oral and Maxillofacial Surgery, Shariati General Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Benazzi S, Stansfield E, Kullmer O, Fiorenza L, Gruppioni G. Geometric morphometric methods for bone reconstruction: the mandibular condylar process of Pico della Mirandola. Anat Rec (Hoboken) 2009; 292:1088-97. [PMID: 19645014 DOI: 10.1002/ar.20933] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The issue of reconstructing lost or deformed bone presents an equal challenge in the fields of paleoanthropology, bioarchaeology, forensics, and medicine. Particularly, within the disciplines of orthodontics and surgery, the main goal of reconstruction is to restore or create ex novo the proper form and function. The reconstruction of the mandibular condyle requires restoration of articulation, occlusion, and mastication from the functional side as well as the correct shape of the mandible from the esthetic point of view. Meeting all these demands is still problematic for surgeons. It is unfortunate that the collaboration between anthropologists and medical professionals is still limited. Nowadays, geometric morphometric methods (GMM) are routinely applied in shape analysis and increasingly in the reconstruction of missing data in skeletal material in paleoanthropology. Together with methods for three-dimensional (3D) digital model construction and reverse engineering, these methods could prove to be useful in surgical fields for virtual planning of operations and the production of customized biocompatible scaffolds. In this contribution, we have reconstructed the missing left condylar process of the mandible belonging to a famous Italian humanist of the 15th century, Pico della Mirandola (1463-1494) by means of 3D digital models and GMM, having first compared two methods (a simple reflection of the opposite side and the mathematical-statistical GMM approach) in a complete human mandible on which loss of the left condyle was virtually simulated. Finally, stereolithographic models of Pico's skull were prototyped providing the physical assembly of the bony skull structures with a high fitting accuracy.
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Affiliation(s)
- Stefano Benazzi
- Department of Palaeoanthropology and Messel Research, Senckenberg Research Institute, Frankfurt am Main, Germany.
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Tang W, Long J, Feng F, Guo L, Gao C, Tian W. Condyle replacement after tumor resection: comparison of individual prefabricated titanium implants and costochondral grafts. ACTA ACUST UNITED AC 2009; 108:147-52. [DOI: 10.1016/j.tripleo.2009.01.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 11/06/2008] [Accepted: 01/05/2009] [Indexed: 11/30/2022]
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Replacement of the Condyle and Ascending Ramus by a Modular Endoprosthesis in Macaca fascicularis— Part 1: A Clinical and Radiographic Study. J Oral Maxillofac Surg 2009; 67:1392-400. [DOI: 10.1016/j.joms.2008.11.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 09/07/2008] [Accepted: 11/25/2008] [Indexed: 01/07/2023]
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Driemel O, Carlson ER, Müller-Richter U, Moralis A, Lienhard S, Wagener S, Reichert TE. Neu entwickeltes Kiefergelenkkopfimplantat zur temporären Kondylus-Rekonstruktion in der ablativen Tumorchirurgie. ACTA ACUST UNITED AC 2007; 11:193-9. [PMID: 17618470 DOI: 10.1007/s10006-007-0062-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Based on own retrospective studies a condylar head add-on system for immediate, temporary reconstruction in patients undergoing ablative surgery requiring the removal of the manibular condyle has been developed in cooperation with the Department of Oral and Maxillofacial Surgery of the University of Tennessee, USA, and the Association for the Study of Internal Fixation (AO/ASIF). PURPOSE The design of the new condylar head add-on system and its use in an anatomical dissection study on a human cadaver are introduced and discussed. DESIGN AND FIRST EXPERIENCES: The condylar replacement is made of commercial pure titanium and is conceived as an add-on system. It consists of a reconstruction plate (2.4 Uni-LOCK-System) und an adaptable condylar head that can be fitted on either side. The offset of the condylar head in a medial direction allows anatomically correct positioning of the implant. The slanted oval head shall provide a large contact area while maintaining function of the mandibular joint. The height-adjustable positioning of the condylar head add-on with four different fixations plates facilitates an intraoperative vertical correction of the condylar head without necessary bending of a new reconstruction plate. A condylar head add-on used on both sides and combined with the frequently used 2.4 Uni-LOCK-plate benefits from reduced storekeeping and turns out to be advantageous from an economic point of view. PERSPECTIVE An international, prospective multi-center study evaluating the intraoperative applicability of the new condylar head add-on system and its functional as well as aesthetic results during the first two postoperative years has started in September 2006.
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Affiliation(s)
- O Driemel
- Klinikum der Universität Regensburg, Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
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Driemel O, Reichert TE. Condylar replacement alone is not sufficient for prosthetic reconstruction of the temporomandibular joint. Int J Oral Maxillofac Surg 2007; 36:665. [PMID: 17391926 DOI: 10.1016/j.ijom.2007.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Accepted: 02/12/2007] [Indexed: 11/22/2022]
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Sembronio S, Albiero AM, Polini F, Robiony M, Politi M. Intraoral endoscopically assisted treatment of temporomandibular joint ankylosis: preliminary report. ACTA ACUST UNITED AC 2007; 104:e7-10. [DOI: 10.1016/j.tripleo.2007.01.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 12/29/2006] [Accepted: 01/11/2007] [Indexed: 10/23/2022]
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Meier JKH, Staudenmaier R, Kleinsasser N, Reichert TE, Driemel O. Alleinige Kondylusresektion versus alloplastische Rekonstruktion. HNO 2007; 55 Suppl 1:E33-9. [PMID: 17415535 DOI: 10.1007/s00106-007-1565-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
After condylar resection a decision on whether to proceed immediately to reconstruction has to be decided. In this paper, two patients who had undergone hemimandibulectomy including exarticulation, in one because of an expanded keratocystic odontogenic tumour and in the other because of oral squamous cell carcinoma, are presented. In one patient a metallic condylar reconstruction plate combined with an iliac crest graft was implanted for primary mandibular reconstruction, whereas in the other the part of the mandible that had been removed and the condylar head were not replaced. One patient was followed up for 5 years and the other for 6 years. Functional (max. incisal distance, protrusive and lateral excursions, occlusion and joint noises) and cosmetic results (scarring, facial nerve function), and also quality of life with and without primary mandibular replacement by a metallic condylar reconstruction plate are compared.
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Affiliation(s)
- J K-H Meier
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Klinikum der Universität Regensburg
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