Linsen Sabine S, Reich Rudolf H, Teschke Marcus
Department of Prosthodontics, Preclinical Education, and Dental Materials Science, University Hospital Bonn, Bonn, Germany.
J Oral Maxillofac Surg. 2012 Sep;70(9):2057-64. doi: 10.1016/j.joms.2012.05.026.
The purpose was to analyze the mandibular patterns (condylar range of motion during opening; incisal range of motion during opening, lateral excursion, and protrusion; velocity during opening and closing; mandibular rotation angle during opening and closing) in patients with alloplastic total joint replacement (TJR).
Seventeen patients with different diagnoses resulting in condylar hypomobility (8 patients, 15 joints) and condylar instability (9 patients, 12 joints) had undergone alloplastic TJR. Data were recorded preoperatively and 2, 6, and at least 12 months postoperatively. For ordinal data comparison at different time points, the Wilcoxon signed-ranks test was used.
Analysis of the kinematic data at least 12 months postoperatively showed in patients with condylar hypomobility a statistically significant increase in all measured data except the incisal range of motion lateral excursion. In patients with condylar instability, the results showed a statistically significant decrease for incisal range of motion protrusion and laterotrusion. A slight increase in condylar range of motion, incisal range of motion linear distance, and velocity during opening and closing was found.
Even after successful alloplastic TJR, a complete restoration of normal joint function is not achievable. Nevertheless, the kinematic data indicate that alloplastic TJR results in an improved function in patients with joint hypomobility and in a decrease of abnormal hypermobility in patients with condylar instability.
分析接受人工全关节置换术（TJR）患者的下颌模式（开口时髁突运动范围；开口、侧方运动和前伸时切牙运动范围；开合时速度；开合时下颌旋转角度）。
17例因不同诊断导致髁突活动度降低（8例患者，15个关节）和髁突不稳定（9例患者，12个关节）的患者接受了人工TJR。术前以及术后2个月、6个月和至少12个月记录数据。对于不同时间点的有序数据比较，采用Wilcoxon符号秩检验。
术后至少12个月的运动学数据分析显示，髁突活动度降低的患者，除切牙侧方运动范围外，所有测量数据均有统计学显著增加。髁突不稳定的患者，结果显示切牙前伸和侧方运动范围有统计学显著降低。发现髁突运动范围、切牙运动线性距离以及开合时速度略有增加。
即使人工TJR成功，也无法完全恢复正常关节功能。然而，运动学数据表明，人工TJR可改善关节活动度降低患者的功能，并降低髁突不稳定患者的异常活动过度。
