Mommers X A, Wajszczjak L, Zwetyenga N
Service de chirurgie maxillo-faciale, chirurgie plastique, reconstructrice, esthétique et chirurgie de la main, faculté de médecine, université de Bourgogne, CHU, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
Service de chirurgie maxillo-faciale, chirurgie plastique, reconstructrice, esthétique et chirurgie de la main, faculté de médecine, université de Bourgogne, CHU, boulevard de Lattre-de-Tassigny, 21000 Dijon, France.
Rev Stomatol Chir Maxillofac Chir Orale. 2014 Feb;115(1):10-4. doi: 10.1016/j.revsto.2013.07.014. Epub 2013 Sep 12.
Temporomandibular joint (TMJ) disorders are usually managed medically. But partial or total reconstruction may be indicated according to the severity and the functional impairment. We assessed the functional results after total TMJ reconstruction using the Biomet Microfixation® prosthesis (Jacksonville, FL, USA).
We reviewed the files of patients having undergone reconstruction, between 2009 and 2010, with a total TMJ prosthesis. We analyzed the pre- and postoperative mouth opening, the pre- and postoperative occlusion, pre- and postoperative pain according to a simple spoken scale ranging from 0 (no pain) to 4 (severe pain).
Twelve total TMJ prostheses were placed in five women and three men (mean age 49.2 years). Restriction of mouth opening was the first cause of consultation. The etiology was trauma for four patients. Three patients had preoperative malocclusion. Four patients had bilateral reconstruction. Preoperative pain ranged between 2 and 4. The average initial mouth opening was 17.8mm. There was neither infection nor any major complication. No prosthesis was removed. The mean follow-up was 18.5 months. At the end of the study, pain ranged between 0 and 2. All patients with preoperative malocclusion resumed an Angle class I postoperatively. The average postoperative mouth opening was 39.5mm.
Total TMJ reconstruction with the Biomet Microfixation® prosthesis improves mouth opening and reduces pain.
颞下颌关节（TMJ）紊乱通常采用药物治疗。但根据严重程度和功能损害情况，可能需要进行部分或全部重建。我们评估了使用Biomet Microfixation®假体（美国佛罗里达州杰克逊维尔）进行全颞下颌关节重建后的功能结果。
我们回顾了2009年至2010年间接受全颞下颌关节假体重建患者的病历。我们根据从0（无疼痛）到4（剧痛）的简单口述量表分析了术前和术后的张口度、术前和术后的咬合情况、术前和术后的疼痛情况。
12个全颞下颌关节假体植入了5名女性和3名男性体内（平均年龄49.2岁）。张口受限是就诊的首要原因。病因是4名患者为外伤。3名患者术前存在错牙合。4名患者进行了双侧重建。术前疼痛程度在2至4之间。平均初始张口度为17.8毫米。未发生感染或任何重大并发症。没有取出假体。平均随访时间为18.5个月。在研究结束时，疼痛程度在0至2之间。所有术前有错牙合的患者术后均恢复为安氏I类咬合。术后平均张口度为39.5毫米。
使用Biomet Microfixation®假体进行全颞下颌关节重建可改善张口度并减轻疼痛。
