title: Total temporomandibular joint replacement: a clinical case with a proposal for post-surgical rehabilitation.
abstract: OBJECTIVE
  The literature on total alloplastic temporomandibular joint (TMJ) reconstructions is encouraging, and studies on total alloplastic TMJ replacements' outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, a better standardization of both surgical and post-surgical phases should further improve the efficacy of treatment.
  
  
  METHODS
  The case report describes the surgical and post-surgical phases of treatment in a patient who underwent a total unilateral joint replacement for TMJ ankylosis, along with a proposal for a post-surgical rehabilitation protocol providing strong passive and active physiotherapy and hyaluronic acid injections to the contralateral joint.
  
  
  RESULTS
  The post-operative (PO) course was uneventful. The patient showed a marked improvement up to about 60% in mouth opening and had no pain on either side at the 1-year follow-up.
  
  
  CONCLUSIONS
  In a patient with unilateral TMJ ankylosis, total TMJ replacement was successful. A carefully tailored post-surgical rehabilitation protocol helped the patient to gain a clinically significant improvement in jaw function. Longer follow-up periods are needed to assess the long-term maintenance of results. Clinical trials are strongly recommended to assess the relative efficacy of different PO protocols.
authors.affiliation: TMD Clinic, Department of Maxillofacial Surgery, University of Padua, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guarda-Nardini
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferronato
mesh_terms: D000328:Adult; D000844:Ankylosis / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000379:methods* / Q000534:rehabilitation; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D007270:Injections, Intra-Articular; D007595:Joint Prosthesis; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome; D055675:Viscosupplements / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid