title: Clinical evaluation of patients with temporomandibular joint implants.
abstract: 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.
authors.affiliation: Postdoctoral Fellow, Pain and Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda, MD 20892, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Ta
authors.forename: James C
authors.initials: JC
authors.lastname: Phero
authors.forename: Stanley R
authors.initials: SR
authors.lastname: Pillemer
authors.forename: Hollie
authors.initials: H
authors.lastname: Hale-Donze
authors.forename: Nancy
authors.initials: N
authors.lastname: McCartney-Francis
authors.forename: Albert
authors.initials: A
authors.lastname: Kingman
authors.forename: Mitchell B
authors.initials: MB
authors.lastname: Max
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Gordon
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Wahl
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Dionne
mesh_terms: 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*
chemical_list: D011428:Proplast; D011138:Polytetrafluoroethylene