Clinical evaluation of patients with temporomandibular joint implants.
OBJECTIVE
An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain, and limitation of mandibular opening. We examined the possible relationship between TMJ implants and persistent pain, responses to sensory stimuli, quality of life, and systemic immune dysfunction.


METHODS
This case series (32 patients) were referred from university-based orofacial pain centers and private practices from across the United States. Laboratory and clinical assessments evaluated orofacial pain symptoms, neurologic function, clinical signs and symptoms of rheumatologic disease, physical function, systemic measures of immune function, and behavioral measures.


RESULTS
We found that TMJ implant patients appeared to have altered sensitivity to sensory stimuli, a higher number of tender points with a diagnosis of fibromyalgia, increased self-report of chemical sensitivity, higher psychologic distress and significantly lower functional ability. Systemic illness or autoimmune disease was not evident in this series of TMJ implant patients.


CONCLUSIONS
Significant problems were noted on clinical assessment of TMJ implant patients. This is a US government work. There are no restrictions on its use.
Ta
Lauren E
LE
Postdoctoral Fellow, Pain and Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda, MD 20892, USA.
Phero
James C
JC
Pillemer
Stanley R
SR
Hale-Donze
Hollie
H
McCartney-Francis
Nancy
N
Kingman
Albert
A
Max
Mitchell B
MB
Gordon
Sharon M
SM
Wahl
Sharon M
SM
Dionne
Raymond A
RA
D000328:Adult; D000704:Analysis of Variance; D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000523:psychology; D001327:Autoimmune Diseases / Q000209:etiology; D004781:Environmental Exposure; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D005356:Fibromyalgia / Q000209:etiology; D006801:Humans; D016130:Immunophenotyping; D007595:Joint Prosthesis / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D011428:Proplast / Q000009:adverse effects; D011788:Quality of Life; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint / Q000276:immunology / Q000502:physiology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000523:psychology / Q000601:surgery*
D011428:Proplast; D011138:Polytetrafluoroethylene