Department of Prosthodontics, Preclinical Education and Dental Materials Science, University Hospital Bonn, Germany.
J Craniomaxillofac Surg. 2013 Jul;41(5):423-8. doi: 10.1016/j.jcms.2012.11.037. Epub 2013 Jan 18.
Alloplastic temporomandibular total joint replacement (TJR) for end-stage disease, congenital disorders and following ablative oncological surgery has been shown to reduce pain and improve function. The purpose was to assess the maximum voluntary bite force and maximum interincisal opening (MIO) in patients undergoing alloplastic total temporomandibular 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 TMJ reconstruction. Maximum voluntary bite force and MIO were measured at pre-operatively (T0), 2 (T1), 6 (T2) and 12 (T3) months. For ordinal data comparison at different time-points, the Wilcoxon signed-ranks test was used. There was a significant improvement in maximum voluntary bite force for both, patients with condylar hypomobility (P = 0.003) and condylar instability (P = 0.007). Analysis of MIO revealed a significant improvement at T3 (P = 0.002). Alloplastic TJR would appear to increase maximum voluntary bite force and MIO. Biomechanical integrity of the stomatognathic system and the ability of the patient to triturate food could be improved by alloplastic temporomandibular joint (TMJ) replacement.
全关节置换术（TJR）可用于治疗终末期疾病、先天性疾病和肿瘤切除术后的颞下颌关节疾病，能够减轻疼痛并改善功能。本研究旨在评估全关节置换术后患者的最大自主咬合力和最大开口度（MIO）。17 名因髁突活动受限（8 名患者；15 个关节）和髁突不稳定（9 名患者；12 个关节）而接受全关节置换术的患者被纳入本研究。术前（T0）、术后 2 个月（T1）、6 个月（T2）和 12 个月（T3）时测量最大自主咬合力和最大开口度。采用 Wilcoxon 符号秩检验比较不同时间点的等级资料。髁突活动受限患者（P = 0.003）和髁突不稳定患者（P = 0.007）的最大自主咬合力均显著提高。MIO 分析显示 T3 时显著改善（P = 0.002）。全关节置换术似乎可以增加最大自主咬合力和最大开口度。全关节置换术可以改善患者的咀嚼功能，提高患者的咀嚼能力。
