Aagaard E, Thygesen T
Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark.
Int J Oral Maxillofac Surg. 2014 Oct;43(10):1229-35. doi: 10.1016/j.ijom.2014.05.019. Epub 2014 Jun 19.
This study describes the clinical variables in 61 patients following total alloplastic temporomandibular joint reconstruction (TJR) in which the Biomet Microfixation Patient-Patient-Matched TMJ Implant was used. All patients were classified using the Wilkes classification. The visual analogue scale score for jaw pain intensity, the maximum inter-incisal opening (MIO), and the frequency of adverse events were recorded during follow-up; the mean follow-up was 14.2±8.6 months. Significant improvements were found in the MIO (P<0.0005), except at the 3-year follow-up. Additionally, a significant reduction in pain was observed both short and long term (P<0.0005). The incidence of adverse events was low (seven of the 81 alloplastic joints); two joints needed revision. TJR appears to be a relevant treatment option in patients with a broad range of temporomandibular joint disorders in whom none of the joint components are salvageable because of significant disease. Our patients gained an almost normal range of mouth opening and experienced a significant reduction in pain. Our results are promising, however TJR is associated with some side effects. TJR should be considered when less invasive procedures fail and a comprehensive presurgical work-up has been performed. Ongoing prospective studies are needed to consolidate the possible significant treatment outcomes.
本研究描述了61例接受全异体颞下颌关节重建(TJR)患者的临床变量,其中使用了Biomet微固定患者匹配型颞下颌关节植入物。所有患者均采用威尔克斯分类法进行分类。在随访期间记录下颌疼痛强度的视觉模拟量表评分、最大切牙间开口度(MIO)和不良事件发生频率;平均随访时间为14.2±8.6个月。除了3年随访时,MIO有显著改善(P<0.0005)。此外,短期和长期均观察到疼痛显著减轻(P<0.0005)。不良事件发生率较低(81个异体关节中有7个);2个关节需要翻修。对于因严重疾病而无法挽救任何关节组件的广泛颞下颌关节疾病患者,TJR似乎是一种合适的治疗选择。我们的患者张口度几乎恢复正常,疼痛显著减轻。我们的结果很有前景,然而TJR也伴有一些副作用。当侵入性较小的手术失败且已进行全面的术前检查时,应考虑TJR。需要进行持续的前瞻性研究以巩固可能的显著治疗效果。