title: Two-year prospective study of outcomes following total temporomandibular joint replacement.
abstract: The purpose of this 2-year prospective study was to investigate outcomes achieved with a stock temporomandibular joint (TMJ) replacement system in the management of end-stage TMJ disorders. Fifty-two patients requiring reconstruction (36 unilateral/16 bilateral) were operated on during the period 2006-2012; 68 total prostheses were implanted (Biomet Microfixation TMJ Replacement System). The mean age at surgery was 52.6±11.5 years. Changes in the values of inclusion diagnostic criteria at entry were assessed. These included persistent and significant TMJ pain, functional impairment after failure of other surgical therapies, and imaging evidence consistent with advanced TMJ disease of more than 1-year duration. Subjects were excluded if they presented insufficient quantity/quality of bone to support the TMJ replacement, severe hyperfunctional habits, active infectious disease, or an inability to follow postoperative instructions. Over the 2 years of postoperative follow-up, mean pain intensity was reduced from 6.4±1.4 to 1.6±1.2 (P<0.001), and jaw opening was improved from 2.7±0.9cm to 4.2±0.7cm (P<0.001). During the study period, three of 68 implants (4%) were explanted and new TMJ replacements fitted. The results of this study support the view that the surgical placement of stock TMJ prostheses provides significant long-term improvements in pain and function, with few complications.
authors.affiliation: Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain. Electronic address: lumigon@telefonica.net.
authors.forename: L M
authors.initials: LM
authors.lastname: Gonzalez-Perez
authors.affiliation: Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Fakih-Gomez
authors.affiliation: Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Seville, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Gonzalez-Perez-Somarriba
authors.affiliation: Department of Mechanical and Manufacturing Engineering, Engineering School, University of Seville, Seville, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Centeno
authors.affiliation: Department of Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: J F
authors.initials: JF
authors.lastname: Montes-Carmona
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: prospective study; temporomandibular joint; temporomandibular joint replacement