1
|
Ingawale SM, Goswami T. Design and Finite Element Analysis of Patient-Specific Total Temporomandibular Joint Implants. MATERIALS 2022; 15:ma15124342. [PMID: 35744401 PMCID: PMC9228547 DOI: 10.3390/ma15124342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 02/04/2023]
Abstract
In this manuscript, we discuss our approach to developing novel patient-specific total TMJ prostheses. Our unique patient-fitted designs based on medical images of the patient’s TMJ offer accurate anatomical fit, and better fixation to host bone. Special features of the prostheses have potential to offer improved osseo-integration and durability of the devices. The design process is based on surgeon’s requirements, feedback, and pre-surgical planning to ensure anatomically accurate and clinically viable device design. We use the validated methodology of FE modeling and analysis to evaluate the device design by investigating stress and strain profiles under functional/normal and para-functional/worst-case TMJ loading scenarios.
Collapse
Affiliation(s)
- Shirish M. Ingawale
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, 3640 Col Glen Hwy, Dayton, OH 45435, USA;
| | - Tarun Goswami
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, 3640 Col Glen Hwy, Dayton, OH 45435, USA;
- Department of Orthopaedic Surgery and Sports Medicine, Wright State University, Dayton, OH 45435, USA
- Correspondence: ; Tel.: +1-(937)-775-5120
| |
Collapse
|
2
|
Linsen SS, Schön A, Teschke M, Mercuri LG. Does Maximum Voluntary Clenching Force Pose a Risk to Overloading Alloplastic Temporomandibular Joint Replacement?-A Prospective Cohort Study. J Oral Maxillofac Surg 2021; 79:2433-2443. [PMID: 34280358 DOI: 10.1016/j.joms.2021.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/04/2021] [Accepted: 06/13/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE The amount of maximum voluntary clenching (MVC) force may influence functional loading at the polyethylene/metal bearing surfaces in alloplastic total temporomandibular joint replacement (TMJR). The aim of this study was to measure ipsilateral MVC and estimate the risk for revision due to overloading of the TMJR. METHODS A prospective cohort study design was used to study patients who underwent alloplastic TMJR. The primary predictor was time after TMJR, the secondary predictors were age at TMJR placement, coronoidectomy, prior ipsilateral TMJ surgeries, TMJR design (custom, stock), and bite location. The primary outcome variable was MVC, the secondary outcome was need for TMJR revision. Data were collected preoperatively (T0), and 1 year (T1), 2 to 3 years (T2) and ≥4 years postoperatively (T3). Analysis of variance (ANOVA) with post hoc Tukey-HSD and regression analysis was used for statistical analysis. P < .05 was considered significant. RESULTS Thirty-seven patients (58 TMJR) with unilateral (n = 16) and bilateral (n = 21) TMJR were enrolled; 8 males (12 TMJR) and 29 females (46 TMJR). Average age was 46.4 ± 14.9 years. MVC increased significantly over the observation period (P = .000). At all observation time points, age at TMJR placement and bite location significantly influenced MVC (P = .000). Coronoidectomy and prior ipsilateral TMJ surgeries did not demonstrate a significant influence on MVC. TMJR design influenced MVC significantly at T3 (P = .006). Regression analysis identified age as a significant factor for higher MVC. No TMJR required revision or replacement. CONCLUSIONS Based on this study, ipsilateral MVC increases significantly after TMJR. However, since MVC is significantly lower than in healthy test-patients, a considerably lower functional loading at the polyethylene/metal bearing surfaces can be assumed. Lower loading at the TMJR bearing surfaces and at the cortical screw fixation sites suggest a potential longer lifespan compared to other artificial joints like hip and knee prostheses.
Collapse
Affiliation(s)
- Sabine S Linsen
- Priv.-Doz., Dr. med. dent., MSc, Assistant Professor, Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Bonn, Germany.
| | - Andreas Schön
- Dr. med., Dr. med. dent., Assistant Professor, Department of Oral- and Maxillofacial Plastic Surgery, University Hospital Bonn, Bonn, Germany
| | - Marcus Teschke
- Dr. med., Dr. med. dent., Private Practice, Praxis fuer Gesichtschirurgie und Kiefergelenkschirurgie, Hamburg, Germany
| | - Louis G Mercuri
- Visiting Professor, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL; Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL; Clinical Consultant, TMJ Concepts, Ventura, CA
| |
Collapse
|
3
|
Ângelo DF, Cardoso HJ, Sanz D. Synovial entrapment in alloplastic temporomandibular joint replacement. Int J Oral Maxillofac Surg 2021; 50:1628-1631. [PMID: 34112570 DOI: 10.1016/j.ijom.2021.05.022] [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: 02/12/2021] [Revised: 04/10/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
Complications of alloplastic temporomandibular joint (TMJ) prostheses can lead to stress and anxiety for the patient and the surgical team, and prosthesis substitution is sometimes required. The aim of this case report is to describe the surgical finding of synovial entrapment with interposed fibrosis in a postoperative alloplastic TMJ revision, managed effectively with adequate surgical debridement. The authors believe that synovial entrapment needs to be considered as a possible postoperative complication of total joint replacement when no clear symptoms of infection, metal hypersensitivity, osteolysis, or heterotopic bone formation are present. The implications of synovial entrapment in TMJ alloplastic replacement remains relatively unpredictable and poorly understood.
Collapse
Affiliation(s)
- D F Ângelo
- Instituto Português da Face, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
| | - H J Cardoso
- Instituto Português da Face, Lisboa, Portugal
| | - D Sanz
- Instituto Português da Face, Lisboa, Portugal
| |
Collapse
|
4
|
Sarlabous M, El-Rabbany M, Caminiti M, Psutka DJ. Alloplastic Temporomandibular Joint Replacement in Patients With Systemic Inflammatory Arthritis and Connective Tissue Disorders. J Oral Maxillofac Surg 2021; 79:2240-2246. [PMID: 34119479 DOI: 10.1016/j.joms.2021.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/17/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE We present a retrospective study to report the outcomes of total temporomandibular joint (TMJ TJR) replacement with alloplastic devices in patients suffering from systemic inflammatory arthropathies. METHODS A total of 39 patients with a diagnosis of rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PA), juvenile idiopathic rheumatoid arthritis (JIA), or systemic lupus, underwent alloplastic total joint replacement(s) (TJR) from 1999 to 2019. Maximal interincisal opening (in mm) was recorded before surgery (T0), at 1-year post-surgery (T1) and at last follow-up (T2). A visual analog scale (from 0 to 10) was used for subjective examination of pain before surgery (T0) and at last follow-up (T2). Comparisons were conducted with statistical significance set at P < .05. RESULTS Seventy-four joints were replaced in 39 patients. Thirty-two were female. The mean age was 36 years old (range 18-61) and the mean follow-up was 45.9 months (SD 49.4). The most common diagnosis was RA (n = 21), followed by JIA (n = 5) and AS (n = 5), PA (n = 4), lupus (n = 3), and mixed connective tissue disorder (n = 1). The mean pain score had fallen from 6.8 (SD 3.2) at T0 to 1.3 (SD 2.4) (P < .001) at T2. The maximal interincisal opening had improved from a mean of 22.1 mm (SD 13.3) at T0 to 34.3 mm (SD 8.5) (P < .001) at T2. One patient got persistent dysesthesia in the V3 distribution. There were no serious late complications. CONCLUSION Patients suffering from systemic inflammatory arthropathies involving the TMJs can be successfully treated by TJR with alloplastic devices. The long-term reduction of TMJ symptoms and functional improvement in this initial study suggest good predictability for this treatment.
Collapse
Affiliation(s)
- Mathilde Sarlabous
- Attending Oral and Maxillofacial Surgeon and director, TMJ Surgery Program, Laval University, Quebec City. Canada; Co-founder, Sinai Health System Centre for Excellence in TMJ Surgery.
| | | | - Marco Caminiti
- Assistant professor and Head, University of Toronto Oral and Maxillofacial Surgery Program, Toronto, Canada; Co-director, University of Toronto Fellowship Program in Advanced TMJ and Orthognathic Surgery; Director, University of Toronto Centre for Advanced Jaw Surgery; Chief, Department of Oral and Maxillofacial Surgery, Humber River Regional Hospital, Toronto, Canada
| | - David J Psutka
- Assistant Professor, University of Toronto Department of Oral and Maxillofacial Surgery; Co-founder, Sinai Health System Centre for Excellence in TMJ Surgery; Co-director, University of Toronto Fellow ship Program in Advanced TMJ and Orthognathic Surgery
| |
Collapse
|
5
|
Davis CM, Hakim M, Choi DD, Behrman DA, Israel H, McCain JP. Early Clinical Outcomes of Arthroscopic Management of the Failing Alloplastic Temporomandibular Joint Prosthesis. J Oral Maxillofac Surg 2020; 78:903-907. [DOI: 10.1016/j.joms.2020.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/07/2020] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Patel MH, Kim RY, Aronovich S, Skouteris CA. Clinical assessment of acellular dermal matrix (AlloDerm©) as an option in the replacement of the temporomandibular joint disc: A pilot study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:496-500. [PMID: 31904524 DOI: 10.1016/j.jormas.2019.12.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 12/15/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is limited data available in the literature describing the utility of acellular dermal matrix (AlloDerm©) in the replacement of the temporomandibular joint disc. Few reports of clinicians using implantable AlloDerm to replace the disc do exist, however, this has been described for reconstruction after surgical resection of the entire temporomandibular joint complex to treat pathology, as opposed to isolated articular disc disorders. Moreover, there is a lack of description in the literature regarding associated perioperative outcomes after such a procedure. We sought to assess the immediate perioperative outcomes in the form of a pilot study, to determine whether this technique warrants further investigation in the form of prospective clinical studies. METHODS The study team conducted a retrospective review of medical records for patients who underwent temporomandibular joint discectomy and replacement with AlloDerm© at a single tertiary care center, from 2011 to 2016. Perioperative outcomes of interest including pain levels and range of motion were recorded and descriptive statistics were utilized for statistical analysis. RESULTS 15 patients met the inclusion criteria, of which 87% were females and 13% males. The mean age was 47.27±15.93 years. Preoperatively, 74% of the patients reported severe pain (VAS scores of 7-10); in contrast, 73% of the patients reported only mild pain (VAS scores of 1-3) during the postoperative visits, suggesting an overall reduction in pain intensity. Range of motion also improved from an average of 27.73±13.04mm, to an average of 38.60±6.08mm (P<0.01). CONCLUSIONS Based on our preliminary data, patients with advanced TMJ articular disc disorders showed clinical improvement from discectomy and replacement with acellular dermal matrix (AlloDerm©). Further longitudinal studies evaluating long-term outcomes need to be conducted to validate this technique, in the form of larger sample sizes with a control group, as well as radiographic assessment of long-term clinical outcomes.
Collapse
Affiliation(s)
- M H Patel
- University of Maryland Medical Center, Department of Oral and Maxillofacial Surgery, 22 S Greene Street, 21201 Baltimore, USA.
| | - R Y Kim
- Head and Neck Oncologic and Microvascular Reconstructive Surgery, John Peter Smith Hospital, Baylor Scott & White, Fort Worth, TX, USA
| | - S Aronovich
- University of Michigan Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - C A Skouteris
- University of Michigan Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| |
Collapse
|
8
|
Gonzalez-Perez LM, Gonzalez-Perez-Somarriba B, Centeno G, Vallellano C, Montes-Carmona JF, Torres-Carranza E, Ambrosiani-Fernandez J, Infante-Cossio P. Prospective study of five-year outcomes and postoperative complications after total temporomandibular joint replacement with two stock prosthetic systems. Br J Oral Maxillofac Surg 2019; 58:69-74. [PMID: 31708224 DOI: 10.1016/j.bjoms.2019.10.312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 10/24/2019] [Indexed: 11/18/2022]
Abstract
To evaluate and compare outcomes and complications associated with reconstruction of the temporomandibular joint (TMJ), we prospectively analysed the data of 70 patients who had their joints replaced with stock prostheses during the period 2004-14 and who had been followed up for five years. We used two types of stock prostheses: the metal-on-metal Christensen system (CS), and the ultra-high-molecular-weight-polyethylene-on-metal Biomet® system (BS). Data were collected at 3, 6, 12, 24, 36, 48, and 60 months postoperatively and compared with preoperative measurements. Five years after the replacement there was an increase in mean (SD) mouth opening from 2.0 (0.6) to 4.0 (0.5cm) (p=0.012) in the CS, and from 2.5 (1.0) cm to 4.1 (0.6) cm (p=0.018) in the BS. The mean (SD) reductions in visual analogue pain scores were from 6.9 (1.6) to 2.0 (1.4) (p=0.001) in the CS, and 6.5 (1.4) to 1.5 (1.1) (p=0.001) in the BS. There were no significant differences in improvements in mouth opening or reduction in pain between the two groups. However, there were differences in the number of implants that failed, which led to removal and replacement of 2/14 prostheses in the CS group and 3/77 in the BS group (p=0.06). The results supported the placement of stock prostheses, as evidenced by a low incidence of complications and adverse events, and a long-term improvement in function and reduction in pain in the TMJ. The BS group had significantly fewer prosthetic failures than the CS group.
Collapse
Affiliation(s)
- L M Gonzalez-Perez
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.
| | - B Gonzalez-Perez-Somarriba
- Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Spain
| | - G Centeno
- Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Spain
| | - C Vallellano
- Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Spain
| | - J F Montes-Carmona
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
| | - E Torres-Carranza
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
| | - J Ambrosiani-Fernandez
- Department of Human Anatomy and Embryology, School of Medicine, University of Seville, Spain
| | - P Infante-Cossio
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
| |
Collapse
|
9
|
Mamidi SK, Klutcharch K, Rao S, Souza JCM, Mercuri LG, Mathew MT. Advancements in temporomandibular joint total joint replacements (TMJR). Biomed Eng Lett 2019; 9:169-179. [PMID: 31168422 DOI: 10.1007/s13534-019-00105-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/23/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022] Open
Abstract
The goal of this paper is to review the advantages and disadvantages of the various treatment options of temporomandibular joint (TMJ) total joint replacement (TJR). TMJ articles published within the last 20 years were reviewed to collect the information on non-invasive and invasive TMD treatment methods. Recent technological advancements helped the evolution of treatment methods and offered significant value to TMD patients and surgeons. Considering the TMD levels, the therapeutic procedures can involve general health examiniations, physical therapy, medication, oral rehabilation or as an end stage clinical invention, temporomandibular joint replacement. In fact when intra-articular TMD is present, the effective treatment method appears to be TJR. However, concern for infection, material hypersensitivity, device longevity and screws loosening issues still exists. Further combined research utilizing the knowledge and expertise of, surgeons, material scientists, and bioengineers is needed for the development of improved TMD therapeutic treatment.
Collapse
Affiliation(s)
- Siva Kumar Mamidi
- 1Department of Biomedical Science, School of Medicine, University of Illinois College of Medicine at Rockford, Rockford, IL 61107 USA
| | - Kristin Klutcharch
- 2Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - Shradha Rao
- 1Department of Biomedical Science, School of Medicine, University of Illinois College of Medicine at Rockford, Rockford, IL 61107 USA
| | - Julio C M Souza
- 3Center for MicroElectroMechanical System (CMEMS-UMINHO), Universidade do Minho, 4800-058 Guimaraes, Portugal.,Department of Dental Sciences, University Institute of Health Science (IUCS-CESPU), 4800-058 Gandra, Portugal
| | - Louis G Mercuri
- 5Present Address: Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612 USA.,TMJ Concepts, Ventura, CA USA
| | - Mathew T Mathew
- 1Department of Biomedical Science, School of Medicine, University of Illinois College of Medicine at Rockford, Rockford, IL 61107 USA.,2Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612 USA
| |
Collapse
|
10
|
Chowdhury SKR, Saxena V, Rajkumar K, Shadamarshan RA. Evaluation of Total Alloplastic Temporomandibular Joint Replacement in TMJ Ankylosis. J Maxillofac Oral Surg 2018; 18:293-298. [PMID: 30996554 DOI: 10.1007/s12663-018-1136-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 07/14/2018] [Indexed: 10/28/2022] Open
Abstract
Introduction Total joint reconstruction using autologous or alloplastic materials is one of the treatment options for the reconstruction of the affected joint in TMJ ankylosis. The clinical results of alloplastic TM joint replacement (Biomet Microfixation system) that was carried out for the treatment and reconstruction of TMJ ankylosis have been summarised. Materials and Methods A retrospective analysis of eight cases clinically and radiographically diagnosed as TMJ ankylosis with minimal facial asymmetry presenting beyond the growth period and willing for at least 12 months of follow-up who have been taken up for gap arthroplasty and reconstruction using Biomet Microfixation TMJ replacement system was carried out. Follow-up of these patients was carried out at regular intervals and assessed on the following criteria: maximal interincisal mouth opening, TM joint pain on the affected side (on VAS), lateral mandibular excursions to the unaffected side deviation on mouth opening, occlusal discrepancy and neuromotor deficit of peripheral branches of facial nerve. Results The mean maximal interincisal mouth opening pre-surgery and 1 year post-surgery was 2 and 31.8 mm, respectively. The mean lateral excursive movement to the unaffected side was found to be 5.5 mm with mean deviation on mouth opening to be 4.6 mm. No pain, occlusal discrepancy or neurological deficit existed at the end of 1 year. Conclusion Biomet Microfixation system is a viable treatment option for reconstruction of TMJ in cases of ankylosis with no major complications.
Collapse
Affiliation(s)
- Sanjay Kumar Roy Chowdhury
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Vivek Saxena
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | - Krishnaprabhu Rajkumar
- Department of Dental Surgery and Oral Health Sciences, Armed Forces Medical College, Pune, Maharashtra 411040 India
| | | |
Collapse
|
11
|
De Meurechy N, Mommaerts M. Alloplastic temporomandibular joint replacement systems: a systematic review of their history. Int J Oral Maxillofac Surg 2018; 47:743-754. [DOI: 10.1016/j.ijom.2018.01.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/07/2017] [Accepted: 01/22/2018] [Indexed: 12/16/2022]
|
12
|
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]
|
13
|
Mercuri LG, Urban RM, Hall DJ, Mathew MT. Adverse Local Tissue Responses to Failed Temporomandibular Joint Implants. J Oral Maxillofac Surg 2017; 75:2076-2084. [DOI: 10.1016/j.joms.2017.03.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/24/2017] [Accepted: 03/24/2017] [Indexed: 11/30/2022]
|
14
|
Two different techniques of manufacturing TMJ replacements – A technical report. J Craniomaxillofac Surg 2017; 45:1432-1437. [DOI: 10.1016/j.jcms.2017.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 05/07/2017] [Accepted: 06/02/2017] [Indexed: 11/19/2022] Open
|
15
|
Lotesto A, Miloro M, Mercuri L, Sukotjo C. Status of alloplastic total temporomandibular joint replacement procedures performed by members of the American Society of Temporomandibular Joint Surgeons. Int J Oral Maxillofac Surg 2017; 46:93-96. [DOI: 10.1016/j.ijom.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/06/2016] [Accepted: 08/01/2016] [Indexed: 11/28/2022]
|
16
|
Gonzalez-Perez LM, Gonzalez-Perez-Somarriba B, Centeno G, Vallellano C, Montes-Carmona JF. Evaluation of total alloplastic temporo-mandibular joint replacement with two different types of prostheses: A three-year prospective study. Med Oral Patol Oral Cir Bucal 2016; 21:e766-e775. [PMID: 27475697 PMCID: PMC5116120 DOI: 10.4317/medoral.21189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/08/2016] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Temporo-Mandibular Joint (TMJ) replacement has been used clinically for years. The objective of this study was to evaluate outcomes achieved in patients with two different categories of TMJ prostheses. MATERIAL AND METHODS All patients who had a TMJ replacement (TMJR) implanted during the study period from 2006 through 2012 were included in this 3-year prospective study. All procedures were performed using the Biomet Microfixation TMJ Replacement System, and all involved replacing both the skull base component (glenoid fossa) and the mandibular condyle. RESULTS Fifty-seven patients (38 females and 19 males), involving 75 TMJs with severe disease requiring reconstruction (39 unilateral, 18 bilateral) were operated on consecutively, and 68 stock prostheses and 7 custom-made prostheses were implanted. The mean age at surgery was 52.6±11.5 years in the stock group and 51.8±11.7 years in the custom-made group. In the stock group, after three years of TMJR, results showed a reduction in pain intensity from 6.4±1.4 to 1.6±1.2 (p<0.001), and an improvement in jaw opening from 2.7±0.9 cm to 4.2±0.7 cm (p<0.001). In the custom-made group, after three years of TMJR, results showed a reduction in pain intensity from 6.0±1.6 to 2.2±0.4 (p<0.001), and an improvement in jaw opening from 1.5±0.5 cm to 4.3±0.6 cm (p<0.001). No statistically significant differences between two groups were detected. CONCLUSIONS The results of this three-year prospective study support the surgical placement of TMJ prostheses (stock prosthetic, and custom-made systems), and show that the approach is efficacious and safe, reduces pain, and improves maximum mouth opening movement, with few complications. As such, TMJR represents a viable technique and a stable long-term solution for cranio-mandibular reconstruction in patients with irreversible end-stage TMJ disease. Comparing stock and custom-made groups, no statistically significant differences were detected with respect to pain intensity reduction and maximum mouth opening improvement.
Collapse
Affiliation(s)
- L-M Gonzalez-Perez
- Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Av. Manuel Siurot s/n, 41013 Seville. Spain,
| | | | | | | | | |
Collapse
|
17
|
Alloplastic total temporomandibular joint replacements: do they perform like natural joints? Prospective cohort study with a historical control. Int J Oral Maxillofac Surg 2016; 45:1213-21. [DOI: 10.1016/j.ijom.2016.04.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 02/12/2016] [Accepted: 04/28/2016] [Indexed: 11/21/2022]
|
18
|
Onoriobe U, Miloro M, Sukotjo C, Mercuri LG, Lotesto A, Eke R. How Many Temporomandibular Joint Total Joint Alloplastic Implants Will Be Placed in the United States in 2030? J Oral Maxillofac Surg 2016; 74:1531-8. [PMID: 27186874 DOI: 10.1016/j.joms.2016.04.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/15/2016] [Accepted: 04/15/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study is to provide a statistical projection of the number of alloplastic temporomandibular joint (TMJ) total joint replacements (TJRs) that will be performed in the United States through the year 2030. MATERIALS AND METHODS The program directors of all 101 Commission on Dental Accreditation-accredited oral and maxillofacial surgery training programs in the United States were surveyed online by use of a questionnaire developed using Redcap (Chicago, IL) over a 6-week period (February 2015-March 2015). The questionnaire included 19 questions related to each program's TMJ disorder and TMJ TJR curricula, as well as clinical experience. In addition, members of the American Society of Temporomandibular Joint Surgeons were surveyed online using Redcap and via direct survey forms. Moreover, requests for the total number of TMJ TJR devices produced and implanted during the same period were made to the 3 manufacturers of Food and Drug Administration-approved TMJ TJR devices in the United States. RESULTS The response rate among program directors was 52.5%, and the total number of TMJ TJR devices implanted in oral and maxillofacial surgery programs in 2005 was 412. This total increased by 38% to 572 in 2014. Statistically, this projects an increase of 58% over the next 16 years to 902 TMJ TJR operations by 2030 (95% prediction limits, 768 and 1,037). The total number of TMJ TJR devices distributed by one manufacturer increased from 430 in the year 2000 to 1,004 in 2014 (133%). By use of these data, statistically over the next 16 years, the number of TMJ TJR devices distributed by this company is projected to be 1,658 (95% prediction limits, 1,380 and 1,935). CONCLUSIONS The data presented in this study show an increasing demand for the use of TMJ TJR devices in the management of end-stage TMJ disorders to the year 2030.
Collapse
Affiliation(s)
- Uvoh Onoriobe
- Dental Student, College of Dentistry, University of Illinois at Chicago, Chicago, IL
| | - Michael Miloro
- Professor and Head, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, IL.
| | - Cortino Sukotjo
- Associate Professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL
| | - Louis G Mercuri
- Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; Clinical Consultant, TMJ Concepts, Ventura, CA
| | - Anthony Lotesto
- Dental Student, College of Dentistry, University of Illinois at Chicago, Chicago, IL
| | - Ransome Eke
- Clinical Instructor, Department of Pediatrics, School of Medicine, University of South Carolina, Greenville, SC
| |
Collapse
|
19
|
Mesnard M, Ramos A. Experimental and numerical predictions of Biomet(®) alloplastic implant in a cadaveric mandibular ramus. J Craniomaxillofac Surg 2016; 44:608-15. [PMID: 27017105 DOI: 10.1016/j.jcms.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/11/2016] [Accepted: 02/03/2016] [Indexed: 10/22/2022] Open
Abstract
The purpose of this study was to evaluate experimentally the behaviors of an intact and an implanted cadaveric ramus, to compare and analyze load mechanism transfers between two validated finite element models. The intact, clean cadaveric ramus was instrumented with four rosettes and loaded with the temporal reaction load. Next, the Biomet microfixation implant was fixed to the same cadaveric mandibular ramus after resection. The mandibular ramus was reconstructed from computed tomographic images, and two finite element models were developed. The experimental results for the mandibular ramus present a linear behavior of up to 300 N load in the condyle, with the Biomet implant influencing strain distribution; the maximum influence was near the implant (rosette #4) and approximately 59%. The experimental and numerical results present a good correlation, with the best correlation in the intact ramus condition, where R(2) reaches 0.935 and the slope of the regression line is 1.045. The numerical results show that screw #1 is the most critical, with maximum principal strains in the bone around 21,000 με, indicating possible bone fatigue and fracture. The experimental results show that the Biomet temporomandibular joint mandibular ramus implant changes the load transfer in the ramus, compared to the intact ramus, with its strain-shielding effect. The numerical results demonstrate that only three screws are important for the Biomet TMJ fixation. These results indicate that including two proximal screws should reduce stresses in the first screws and strains in the bone.
Collapse
Affiliation(s)
- M Mesnard
- Université de Bordeaux, Institut de Mécanique et d'Ingénierie, CNRS UMR, 5295, Talence, France
| | - A Ramos
- Biomechanics Research Group, Department of Mechanical Engineering, University of Aveiro, Portugal.
| |
Collapse
|
20
|
Gonzalez-Perez LM, Fakih-Gomez N, Gonzalez-Perez-Somarriba B, Centeno G, Montes-Carmona JF. Two-year prospective study of outcomes following total temporomandibular joint replacement. Int J Oral Maxillofac Surg 2015; 45:78-84. [PMID: 26377771 DOI: 10.1016/j.ijom.2015.08.992] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/05/2015] [Accepted: 08/26/2015] [Indexed: 10/23/2022]
Abstract
The purpose of this 2-year prospective study was to investigate outcomes achieved with a stock temporomandibular joint (TMJ) replacement system in the management of end-stage TMJ disorders. Fifty-two patients requiring reconstruction (36 unilateral/16 bilateral) were operated on during the period 2006-2012; 68 total prostheses were implanted (Biomet Microfixation TMJ Replacement System). The mean age at surgery was 52.6±11.5 years. Changes in the values of inclusion diagnostic criteria at entry were assessed. These included persistent and significant TMJ pain, functional impairment after failure of other surgical therapies, and imaging evidence consistent with advanced TMJ disease of more than 1-year duration. Subjects were excluded if they presented insufficient quantity/quality of bone to support the TMJ replacement, severe hyperfunctional habits, active infectious disease, or an inability to follow postoperative instructions. Over the 2 years of postoperative follow-up, mean pain intensity was reduced from 6.4±1.4 to 1.6±1.2 (P<0.001), and jaw opening was improved from 2.7±0.9cm to 4.2±0.7cm (P<0.001). During the study period, three of 68 implants (4%) were explanted and new TMJ replacements fitted. The results of this study support the view that the surgical placement of stock TMJ prostheses provides significant long-term improvements in pain and function, with few complications.
Collapse
Affiliation(s)
- L M Gonzalez-Perez
- Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.
| | - N Fakih-Gomez
- Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
| | - B Gonzalez-Perez-Somarriba
- Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Seville, Spain
| | - G Centeno
- Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Seville, Spain
| | - J F Montes-Carmona
- Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain
| |
Collapse
|
21
|
Comparison of load transfers in TMJ replacement using a standard and a custom-made temporal component. J Craniomaxillofac Surg 2014; 42:1766-72. [DOI: 10.1016/j.jcms.2014.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/19/2014] [Accepted: 06/05/2014] [Indexed: 11/17/2022] Open
|
22
|
Mercuri L. Temporomandibular joint replacement periprosthetic joint infections: a review of early diagnostic testing options. Int J Oral Maxillofac Surg 2014; 43:1236-42. [DOI: 10.1016/j.ijom.2014.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 05/16/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
|
23
|
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]
|
24
|
Total alloplastic temporomandibular joint reconstruction using Biomet stock prostheses: the University of Florida experience. Int J Oral Maxillofac Surg 2014; 43:1091-5. [DOI: 10.1016/j.ijom.2014.04.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 03/01/2014] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
|
25
|
Lee SH, Ryu DJ, Kim HS, Kim HG, Huh JK. Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases. J Korean Assoc Oral Maxillofac Surg 2013; 39:297-303. [PMID: 24516821 PMCID: PMC3912785 DOI: 10.5125/jkaoms.2013.39.6.297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/06/2013] [Accepted: 11/25/2013] [Indexed: 12/04/2022] Open
Abstract
Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.
Collapse
Affiliation(s)
- Sang-Hoon Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Da-Jung Ryu
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| |
Collapse
|
26
|
Sidebottom AJ. Alloplastic or autogenous reconstruction of the TMJ. J Oral Biol Craniofac Res 2013; 3:135-9. [PMID: 25737902 PMCID: PMC3942016 DOI: 10.1016/j.jobcr.2013.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 07/29/2013] [Indexed: 11/18/2022] Open
Abstract
Reconstruction of the irreparably damaged temporomandibular joint (TMJ) is dependent on the cause of damage and the patient's age. In childhood the current preference is for autogenous reconstruction which can potentially "grow" with the child. This is either with soft tissue interposition (temporalis fascial interposition), local osteotomy, distraction osteogenesis, non-vascularised tissue (costochondral, sternoclavicular) or vascularised tissue (second metatarsal). Current debate centres around the possibility of alloplastic reconstruction particularly where autogenous tissue has failed. The resultant failure of growth - if this occurs, can be dealt with in late adolescence with either osteotomy, distraction osteogenesis or replacement of the condylar component of the prosthesis. In the adult the choice is currently in favour of alloplastic reconstruction as this gives a more stable long term result and facilitates early mobilisation. Initial cost is clearly an issue, but when weighted against the reduced length of stay and reduced morbidity, often the costs are equivalent in the short term and come to benefit alloplasts in the medium term. Their long term outcomes beyond 15 years are however not clear.
Collapse
Affiliation(s)
- Andrew J. Sidebottom
- Consultant Oral and Maxillofacial Surgeon, Queens Medical Centre, Nottingham NG7 2UH, UK
| |
Collapse
|
27
|
Tan HC, Poh CK, Cai Y, Wang W. Anti-fibrosis effect of BMP-7 peptide functionalization on cobalt chromium alloy. J Orthop Res 2013; 31:983-90. [PMID: 23456668 DOI: 10.1002/jor.22313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 12/20/2012] [Indexed: 02/04/2023]
Abstract
Orthopedic metallic prosthetic implants are commonly made of cobalt chromium (CoCr) alloys. However, such metal-based implants are susceptible to fibrous capsule formation on the implant surface after implantation. At the bone-implant interface, this capsule can prevent implant integration, resulting in loosening and failure. Minimizing the development of such a capsule on the CoCr surface would improve direct bone-implant bonding leading to long-term implant functionality. We evaluated the anti-fibrosis effect of bone morphogenic protein-7 (BMP-7) peptide covalently bonded to CoCr alloy. This peptide, a biomimetic derivation of the knuckle epitope of BMP-7, was conjugated at the N-terminus with a cysteine amino acid. X-ray photoelectron spectroscopy (XPS) and probe binding assay were used to evaluate different stages of grafting and surface functionalization using polydopamine coating. Cellular functions were studied using fibroblast attachment, cell proliferation, and MTT assays. Fibroblasts were grown on functionalized and pristine CoCr substrates, and the efficacy of BMP-7 peptide on anti-fibrosis was analyzed via gene expression and protein expression of fibrosis markers ACTA2, Collagen 1A1, and fibronectin. The peptide functionalized substrates showed significant reduction of fibrosis markers expression after 1 week of incubation compared to controls. BMP-7 signaling pathway activation was shown by the presence of phosphorylation of Smad1/5/8. These findings may contribute to the improvement of CoCr implants in orthopedic surgery applications.
Collapse
Affiliation(s)
- Hark Chuan Tan
- Department of Orthopaedic Surgery, National University of Singapore, Kent Ridge, Singapore 119074, Singapore
| | | | | | | |
Collapse
|
28
|
Tan HC, Poh CK, Cai Y, Soe MT, Wang W. Covalently grafted BMP-7 peptide to reduce macrophage/monocyte activity: An in vitro study on cobalt chromium alloy. Biotechnol Bioeng 2012; 110:969-79. [DOI: 10.1002/bit.24756] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/11/2012] [Accepted: 10/01/2012] [Indexed: 01/23/2023]
|
29
|
Monje F, Mercuri L, Villanueva-Alcojol L, de Mera JJF. Synovial Metaplasia Found in Tissue Encapsulating a Silicone Spacer During 2-Staged Temporomandibular Joint Replacement for Ankylosis. J Oral Maxillofac Surg 2012; 70:2290-8. [DOI: 10.1016/j.joms.2012.06.177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/08/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
|
30
|
Mercuri LG. Alloplastic temporomandibular joint replacement: rationale for the use of custom devices. Int J Oral Maxillofac Surg 2012; 41:1033-40. [PMID: 22771166 DOI: 10.1016/j.ijom.2012.05.032] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 03/20/2012] [Accepted: 05/31/2012] [Indexed: 11/16/2022]
|
31
|
Novel approach to the study of jaw kinematics in an alloplastic TMJ reconstruction. Int J Oral Maxillofac Surg 2012; 41:1041-5. [DOI: 10.1016/j.ijom.2012.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 03/29/2012] [Accepted: 06/22/2012] [Indexed: 11/23/2022]
|