title: Alloplastic total temporomandibular joint replacements: do they perform like natural joints? Prospective cohort study with a historical control.
abstract: The aim of this study was to qualitatively and quantitatively describe the biomechanics of existing total alloplastic reconstructions of temporomandibular joints (TMJ). Fifteen patients with unilateral or bilateral TMJ total joint replacements and 15 healthy controls were evaluated via dynamic stereometry technology. This non-invasive method combines three-dimensional imaging of the subject's anatomy with jaw tracking. It provides an insight into the patient's jaw joint movements in real time and provides a quantitative evaluation. The patients were also evaluated clinically for jaw opening, protrusive and laterotrusive movements, pain, interference with eating, and satisfaction with the joint replacements. The qualitative assessment revealed that condyles of bilateral total joint replacements displayed similar basic motion patterns to those of unilateral prostheses. Quantitatively, mandibular movements of artificial joints during opening, protrusion, and laterotrusion were all significantly shorter than those of controls. A significantly restricted mandibular range of motion in replaced joints was also observed clinically. Fifty-three percent of patients suffered from chronic pain at rest and 67% reported reduced chewing function. Nonetheless, patients declared a high level of satisfaction with the replacement. This study shows that in order to gain a comprehensive understanding of complex therapeutic measures, a multidisciplinary approach is needed.
authors.affiliation: Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland. Electronic address: aleksandra.wojczynska@zzm.uzh.ch.
authors.forename: A
authors.initials: A
authors.lastname: Wojczyńska
authors.affiliation: Department of Cranio-Maxillofacial Surgery, University Hospital Basel, University of Basel, Basel, Switzerland; Hightech Research Centre of Cranio-Maxillofacial Surgery, University Hospital Basel, University of Basel, Basel, Switzerland.
authors.forename: C S
authors.initials: CS
authors.lastname: Leiggener
authors.affiliation: Clinic for Cranio-Maxillofacial Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Bredell
authors.affiliation: Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: D A
authors.initials: DA
authors.lastname: Ettlin
authors.affiliation: Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Erni
authors.affiliation: Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: L M
authors.initials: LM
authors.lastname: Gallo
authors.affiliation: Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Centre of Dental Medicine, University of Zurich, Zurich, Switzerland.
authors.forename: V
authors.initials: V
authors.lastname: Colombo
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement; D001696:Biomechanical Phenomena; D005260:Female; D065386:Historically Controlled Study; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome
keywords: biomechanics; digital volume tomography; mandibular motion; prosthesis; replacement; temporomandibular joint