Department of Oral Maxillofacial Surgery, Charles University and Faculty Hospital Prague, Czech Republic.
Int J Oral Maxillofac Surg. 2012 Apr;41(4):514-7. doi: 10.1016/j.ijom.2011.12.033. Epub 2012 Jan 27.
In 2004, total alloplastic temporomandibular joint (TMJ) replacement began in the Czech Republic and Slovakia. This paper presents initial subjective and objective data compiled between 2005 and 2009 from those cases. Data were collected from 27 patients (38 joints) reconstructed with the Biomet-Lorenz stock and custom TMJ prostheses during a mean follow-up period of 24 months. The variables of pain and mouth opening were evaluated pre- and postoperatively. Patients classified pain on a scale of 0-5 (none - unbearable). The extent of opening was investigated by a physician (the distance between the points of the incisors on the upper and lower jaw was measured). The most common indication for replacement was ankylosis. There was an improvement in pain score in 15 patients. 4 patients reported worsening of pain and 8 patients did not complain of pre- or postoperative pain. Mandibular opening increased from a mean of 17.7 mm preoperatively to a mean of 29.1mm postoperatively. There were complications related to the surgery, but no significant complications related to the devices. Total alloplastic TMJ replacement appears to be a safe and effective method of reconstruction in the patients in this initial study.
2004 年，全关节置换术式的颞下颌关节（TMJ）置换术在捷克共和国和斯洛伐克开始应用。本文呈现了自 2005 年至 2009 年期间收集的初始主观和客观数据。研究纳入了 27 例（38 个关节）接受 Biomet-Lorenz 标准假体和定制 TMJ 假体重建的患者，平均随访时间为 24 个月。分别在术前和术后评估疼痛和张口度。患者将疼痛程度分为 0-5 级（0 级为无痛，5 级为无法忍受的剧痛）。张口度由医生进行评估（测量上下颌切牙间的距离）。最常见的置换适应证为关节强直。15 例患者的疼痛评分有所改善，4 例患者的疼痛加重，8 例患者术前和术后均无疼痛。术后张口度由术前平均 17.7mm 增加至术后平均 29.1mm。手术相关并发症，但无与假体相关的严重并发症。在本初步研究中，全关节置换术式似乎是一种安全有效的 TMJ 重建方法。
