Simultaneous treatment of temporomandibular joint ankylosis with severe mandibular deficiency by standard TMJ prosthesis.
Temporomandibular joint (TMJ) ankylosis is a refractory disease that is difficult to predictably treat. This study evaluated the prognosis of using standard alloplastic TMJ prostheses for the treatment of TMJ ankylosis in Chinese patients with severe mandibular deficiency. Patients treated from 2013 to 2015 were reviewed. The computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Eleven patients were included in this study. All prostheses were successfully installed and stabilized intraoperatively. In 4 patients with severe mandibular deficiency, their mandibular ramus was elongated by the TMJ prosthesis and 2 patients were combined with Le Fort I osteotomy guided by digital templates. Their mean chin advancement was 10.19 mm. Their SNB and ramus heights were also significantly improved after operation (P < 0.05). There was no prosthesis loosening, breakage, or infection leading to removal after a mean follow-up period of 22 months (range, 12-31mos.). Mouth opening was significantly improved from 5.5 mm preoperatively to 31.5 mm postoperatively. TMJ reconstruction with standard alloplastic prosthesis is a reliable treatment for ankylosis, especially in recurrent cases. By CAD/CAM technique, it can correct jaw deformities simultaneously and produce stable results.
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
YiHui
Y
Hu
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
LuZhu
L
Zhang
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
DongMei
D
He
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
Chi
C
Yang
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
MinJie
M
Chen
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
ShanYong
S
Zhang
Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, Key Laboratory of Stomatology, Shanghai, 200011, China.
Hui
H
Li
Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, TX, USA.
Edward
E
Ellis
D000328:Adult; D000844:Ankylosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002681:China; D017076:Computer-Aided Design; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008334:Mandible / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D013704:Temporomandibular Joint / Q000503:physiopathology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome