Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, USA.
Int J Oral Maxillofac Surg. 2012 Apr;41(4):518-20. doi: 10.1016/j.ijom.2011.09.024. Epub 2011 Dec 12.
The purpose of this study was to determine if a temporomandibular joint (TMJ) replaced by a custom joint prosthesis could have been replaced by a stock joint prosthesis. Stereolithic models of patients treated with TMJ Concepts® patient fitted joint prosthesis (e.g., custom) were obtained. Biomet Microfixation® TMJ prostheses (e.g. stock) were adapted to these models. Intra-operative insertion of prosthesis, fit and size of stock joints were simulated and evaluated. Adaptability and stability of condyle and fossa as well as their articulation were recorded. 20 models consisting of 34 joints were examined by two oral and maxillofacial surgeons who were blinded to the patient's diagnosis. Overall, 77% of the stock TMJ system fit the stereolithic models. 3mm or less of bone modification was necessary to achieve an acceptable fit. In the majority of the cases examined, a stock TMJ prosthesis had good anatomical adaptation to stereolithic models of patients previously treated with custom TMJ prosthesis, so a stock TMJ prosthesis could have been an acceptable option for these patients. Further prospective clinical studies to compare both systems are necessary.
本研究旨在确定由定制关节假体置换的颞下颌关节（TMJ）是否可以由标准关节假体置换。获得了接受 TMJ Concepts®患者适配关节假体（例如定制）治疗的患者的立体石模型。将 Biomet Microfixation®TMJ 假体（例如标准）适配到这些模型上。模拟并评估了假体的术中插入、标准关节的适配和尺寸。记录了髁突和关节窝的适应性和稳定性及其关节。由两位口腔颌面外科医生对 20 个模型（共 34 个关节）进行了检查，他们对患者的诊断一无所知。总体而言，77%的标准 TMJ 系统适配立体石模型。需要进行 3mm 或更小的骨修整才能达到可接受的适配。在检查的大多数情况下，标准 TMJ 假体与先前接受定制 TMJ 假体治疗的患者的立体石模型具有良好的解剖适应性，因此标准 TMJ 假体可能是这些患者的可接受选择。需要进一步进行前瞻性临床研究来比较这两种系统。
