Department of Cranio-Maxillofacial Surgery, University Hospital Basel, University of Basel, Basel, Switzerland.
Int J Oral Maxillofac Surg. 2012 Sep;41(9):1041-5. doi: 10.1016/j.ijom.2012.06.014. Epub 2012 Jul 21.
Total alloplastic temporomandibular joint (TMJ) reconstruction is a reliable treatment modality in patients with severely diseased TMJ with good clinical behaviour. TMJ mandibular function after alloplastic reconstruction has scarcely been analysed as a biomechanical parameter and investigation has generally been limited to interincisal measurements without deeper insight into joint kinematics. Dynamic stereometry to assess condylar movements relative to the fossa was performed at the 5 year follow-up of a patient who underwent condylar resection of the right TMJ followed by total alloplastic joint reconstruction to treat pigmented villonodular synovitis. The patient could achieve wide mouth opening, but overall mandibular kinematics showed a strong deviation towards the prosthetic side due to the lack of mandibular translation caused by the absence of the lateral pterygoid attachment. Possible overloading of the joint contralateral to the TMJ prosthesis might be prevented by optimizing replacement joint design.
全假体颞下颌关节（TMJ）重建术是一种可靠的治疗方法，适用于患有严重 TMJ 疾病且具有良好临床行为的患者。全假体重建术后 TMJ 下颌功能很少作为生物力学参数进行分析，研究通常仅限于切牙间测量，而对关节运动学的了解甚少。对一名患有色素绒毛结节性滑膜炎的患者进行右侧 TMJ 髁突切除术及全假体关节重建术治疗后，在 5 年随访时采用动态立体测量法评估髁突相对于关节窝的运动情况。患者可以实现张口，但由于缺乏翼外肌附着导致下颌缺乏平移，整体下颌运动明显偏向假体侧。通过优化置换关节设计，可能可以防止对侧 TMJ 假体关节的过度负荷。
