title: Prospective comparison study of one-year outcomes for all titanium total temporomandibular joint replacements in patients allergic to metal and cobalt-chromium replacement joints in patients not allergic to metal.
abstract: We aimed to ascertain whether there are any early differences in outcome between all titanium temporomandibular joint (TMJ) prostheses in patients allergic to metal and standard cobalt-chromium prostheses in patients not allergic to metal. All patients who had primary TMJ prostheses placed with one-year follow-up between March 2003 and February 2011 were included. We reviewed the basic characteristics of patients. The outcome variables measured included disease, pain, mouth opening, and diet. A total of 55 patients with 77 joint replacements fulfilled the inclusion criteria. Forty patients had standard cobalt-chromium alloy (Co-Cr-Mo) prostheses (20 unilateral and 20 bilateral), and 15 had all titanium prostheses (13 unilateral and 2 bilateral). Osteoarthritis was the most common disease in both groups. There was significant improvement in pain score at reviews at 6 weeks (p=0.001) and 12 months (p=0.03). Values between groups were not significant (p=0.48 at 6 weeks, and p=0.10 at 1 year). Mouth opening in each group improved significantly with continued gains between assessments at 6 weeks and 12 months (p=0.001) but there were no significant differences between groups. Diet scores were significantly improved one year postoperatively in both groups (p=0.001), but differences between groups were not significant (p=0.90). At one year, outcomes for all titanium prostheses in patients allergic to metal were similarly favourable to those in patients who had no hypersensitivity to metal and had standard prostheses. No patient developed a hypersensitivity reaction, and no all titanium prosthesis failed during the one-year follow-up period.
authors.affiliation: Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: omarthusain@yahoo.com.
authors.forename: O T
authors.initials: OT
authors.lastname: Hussain
authors.affiliation: Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: drsksah@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Sah
authors.affiliation: Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom. Electronic address: ajsidebottom@doctors.org.uk.
authors.forename: A J
authors.initials: AJ
authors.lastname: Sidebottom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry*; D002858:Chromium Alloys / Q000737:chemistry*; D004032:Diet; D005157:Facial Pain / Q000145:classification; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010147:Pain Measurement; D011446:Prospective Studies; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery; D014025:Titanium / Q000737:chemistry*; D016896:Treatment Outcome; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D002858:Chromium Alloys; D014025:Titanium
keywords: All-titanium temporomandibular joint replacement; Cobalt–chromium total temporomandibular joint replacement; Degenerative arthritis of the TMJ; Metal-allergic patients; TMJ replacement