[Metallic condylar head prostheses to replace the temporomandibular joint].
BACKGROUND
Up to now the results after condylar reconstruction of the mandible have been regarded as less than satisfactory.


OBJECTIVE
Functional and aesthetic long-term results after condylar head resection in traumatic and tumour cases with or without replacement by a metallic condylar head prosthesis were compared in a retrospective study.


METHODS
From 1980 to 2001, 23 temporomandibular joints of 19 patients were reconstructed with metallic condylar head prostheses. The resected region, the contralateral joint, facial and masticatory muscles and the dental system were clinically and radiographically monitored for a mean period of 4 years and 9 months. Seven patients who underwent condylar resection without substitution were observed over an average follow-up time of 7 years and 11 months.


RESULTS
Patients who underwent condylar resection without substitution reported more trouble with eating and speaking for a long time. TMJ endoprostheses preserved facial symmetry better. Maximum mandibular opening as well as lateral and protrusive excursions were slightly reduced in comparison with both unaffected controls and patients who underwent condylar resection without substitution. In this study bilateral condylar prostheses exhibited the same functional and aesthetic results as unilateral arthroplasty.


CONCLUSIONS
Metallic condylar head prostheses originally developed for temporary replacement worked in some cases as long-term joint replacement but were not able to reach the total functional quality of natural temporomandibular joints.
Driemel
O
O
Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universität Regensburg.
Buch
R S R
RS
Dammer
R
R
Reicheneder
C
C
Reichert
T E
TE
Pistner
H
H
D001860:Bone Plates; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D007574:Jaw Relation Record; D007595:Joint Prosthesis; D008335:Mandibular Condyle / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000534:rehabilitation; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013232:Steel; D013704:Temporomandibular Joint / Q000601:surgery*; D014025:Titanium
D013232:Steel; D014025:Titanium