Amarista Felix Jose, Mercuri Louis G, Perez Daniel
Oral and Maxillofacial Surgery Resident, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; and Clinical Consultant, TMJ Concepts, Ventura, CA.
J Oral Maxillofac Surg. 2020 Oct;78(10):1692-1703. doi: 10.1016/j.joms.2020.05.021. Epub 2020 May 20.
The purpose of the present study was to report the temporomandibular joint (TMJ) alloplastic reconstruction (TMJR) revision and/or replacement rates and associated complication outcomes data gathered from experienced TMJ surgeons and to review the recent relevant data.
A 21-question anonymous on-line survey was sent to all Commission on Dental Accreditation-approved oral and maxillofacial surgery program directors and to members of the European Society of TMJ Surgeons and the American Society of Temporomandibular Joint Surgeons.
Of the surgeons sent the survey, 22% completed the full questionnaire. Most responses were from surgeons who routinely perform TMJR surgery (93.5%). Of the respondents, 28.3% had more than 30 years of experience and 73.9% were full-time academic faculty. A total of 4638 TMJR procedures were recorded and analyzed. The incidence of TMJR revision (keeping the same device) was 3% and that of replacement (placing a new device) was 4.9%. The most common reason for revision was heterotopic ossification (27.5%). The most common reason for replacement was infection (21.1%). Revision was successful in 86.7% and replacement in 94.6% of the patients at the longest follow-up reported.
The data from the present study have shown that the incidence is low and the success rate is high for TMJR revision and replacement.
本研究的目的是报告从经验丰富的颞下颌关节外科医生处收集的颞下颌关节（TMJ）异体植入重建（TMJR）翻修和/或置换率以及相关并发症结果数据，并回顾近期的相关数据。
向所有牙科认证委员会批准的口腔颌面外科项目主任以及欧洲颞下颌关节外科学会和美国颞下颌关节外科学会的成员发送了一份包含21个问题的匿名在线调查问卷。
在收到调查问卷的外科医生中，22%完成了完整问卷。大多数回复来自经常进行TMJR手术的外科医生（93.5%）。在受访者中，28.3%有超过30年的经验，73.9%是全职学术教员。共记录并分析了4638例TMJR手术。TMJR翻修（保留同一装置）的发生率为3%，置换（植入新装置）的发生率为4.9%。翻修最常见的原因是异位骨化（27.5%）。置换最常见的原因是感染（21.1%）。在报告的最长随访中，86.7%的翻修患者和94.6%的置换患者取得成功。
本研究的数据表明，TMJR翻修和置换的发生率低且成功率高。
