Kinematic assessment of the temporomandibular joint before and after partial metal fossa eminence replacement surgery: a prospective study.
OBJECTIVE
This study compared the functional kinematic outcome of the temporomandibular joint (TMJ) in patients with end-stage TMJ osteoarthritis before and after TMJ hemijoint replacement surgery.


METHODS
Fourteen patients (15 joints), with a mean age of 46.1 years, undergoing metal fossa eminence hemijoint replacement surgery, participated in this study. Each patient's jaw motion was recorded using an electromagnetic tracking device and patient-specific computed tomography images. A visual analog scale patient response questionnaire was used before and after the operation to assess the subjective outcome of the surgery.


RESULTS
The mean linear distance (LD) traveled by the incisors increased significantly due to the surgical intervention, from 30.4 +/- 6.9 mm preoperatively to 35.5 +/- 5.3 mm postoperatively (P = .02). The LD of the operated condyle decreased from 14.1 +/- 5.7 mm to 11.4 +/- 6.2 mm, but this was not significant. The mean LD for the unoperated condyle remained similar (preoperative, 13.2 +/- 5.9 mm; postoperative, 13.3 +/- 6.5 mm). The total mandibular rotation increased significantly, from 19.3 +/- 4.9 degrees preoperatively to 24.8 +/- 3.9 postoperatively (P < .01).


CONCLUSIONS
Kinematic data support the functional efficiency of hemijoint replacement surgery, with benefits of increased maximal mouth opening, preservation of operated and unoperated condyle translation motion, and increased mandibular rotation.
Baltali
Evre
E
Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA. evre@baltali.org
Zhao
Kristin D
KD
Koff
Matthew F
MF
Durmuş
Ercan
E
An
Kai-Nan
KN
Keller
Eugene E
EE
D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D002858:Chromium Alloys; D006801:Humans; D007574:Jaw Relation Record; D007595:Joint Prosthesis; D008335:Mandibular Condyle / Q000502:physiology / Q000601:surgery; D008875:Middle Aged; D009068:Movement; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome
D002858:Chromium Alloys