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Arif H, Ashraf R, Khan F, Khattak YR, Nisar H, Ahmad I. Total temporomandibular joint reconstruction prosthesis in hemifacial microsomia: A systematic review. Orthod Craniofac Res 2024; 27:15-26. [PMID: 37533308 DOI: 10.1111/ocr.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
Hypoplastic asymmetry due to hemifacial microsomia (HFM) often represents the most difficult reconstruction in the craniomaxillofacial clinic. Although autogenous grafts are generally used for temporomandibular joint reconstruction (TMJR), the use of TMJR prostheses is not well established. The aim of this review was to identify, collect and analyse the use of extended TMJR (eTMJR) prostheses in patients with HFM, describing clinical features, surgical procedures and postoperative complications. Online searches of all major databases were performed according to PRISMA guidelines. All studies with HFM patients treated with the eTMJR prostheses were included. Descriptive statistics were used for data analysis. A total of 19 studies, including 08 case studies, 06 case series and 05 retrospective cohort studies, met the inclusion criteria, where a total of 42 HFM patients were reported from 18 countries, mostly from the United States (05; 26%). Fifteen of the 42 cases (~36%) were male. The mean ± SD (range) age of patients in all studies was 19.79 ± 5.81 (9-36) years. The mean ± SD (range) of patient follow-up was 41.30 ± 35.50 (6-136) months. A total of 5 (10.6%) patients were implanted with bilateral eTMJR prostheses. The Pruzansky classification was used in 18 (~89.5%) studies, OMENS classification in 01 (~5%) study, whereas no classification was reported in one study. Only 01 (7.1%) study had documented the eTMJR classification for the prosthesis used. In growing patients with or without a history of failed autogenous tissues, TMJR prostheses may provide a viable alternative. Randomized studies with large cohorts are warranted to validate these preliminary results.
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Affiliation(s)
- H Arif
- Nishtar Hospital, Multan, Pakistan
| | - R Ashraf
- Nishtar Hospital, Multan, Pakistan
| | - F Khan
- Services Institute of Medical Sciences, Lahore, Pakistan
| | - Y R Khattak
- Oral and Maxillofacial Surgery, Hayatabad Medical Complex, Peshawar, Pakistan
| | - H Nisar
- Pakistan Institute of Engineering and Applied Sciences (PIEAS), Islamabad, Pakistan
| | - I Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
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Aldosary SN, Tanaka TI. A Young Adult Patient with Rheumatoid Disorder Presents for the Evaluation of Limited Mouth Opening. Dent Clin North Am 2023; 67:633-635. [PMID: 37714612 DOI: 10.1016/j.cden.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
Juvenile Idiopathic Arthritis (JIA), formerly known as Juvenile Rheumatoid Arthritis, includes all forms of chronic arthritis with unknown etiology that occurs before the age of sixteen. Clinical practice guidelines for JIA management have been evolving for the past 10 years. JIA affects approximately 1 per 1000 children in the U.S. causing short and long-term disability. Polyarticular JIA represents 30% to 40% of JIA and affects five or more joints within 6 months of onset, including the smaller joints, such as the temporomandibular joint (TMJ). TMJ involvement in JIA is between 17% and 87% and can cause craniofacial abnormality resulting in significant functional and aesthetic complications. It is important for the oral healthcare provider to recognize common signs and symptoms of JIA and facilitate multidisciplinary patient care for time management and better prognosis.
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Affiliation(s)
- Sara N Aldosary
- Division of Oral Medicine, Department of Oral Medicine Penn Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Takako I Tanaka
- Division of Oral Medicine, Department of Oral Medicine Penn Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
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Seo YS, Park HJ, Yu SK, Jeong SR, Ryu JW. Evaluation of Cortical Bone Formation on Mandibular Condyle in Asymptomatic Adolescents and Young Adults Using Cone-Beam Computed Tomography. Life (Basel) 2022; 12:life12122032. [PMID: 36556397 PMCID: PMC9785755 DOI: 10.3390/life12122032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 12/09/2022] Open
Abstract
The aim of this study was to evaluate cortical bone formation on the mandibular condyle using cone-beam computed tomography (CBCT) in asymptomatic adolescents and young adults and to evaluate the relationship between age and sex. CBCT images that can evaluate the shape of the mandibular condyle were selected from asymptomatic patients aged 13−25. The degree of cortication on the mandibular condyle (CMC) was evaluated using CBCT images reconstructed in the axial, sagittal, and coronal planes. CBCT data of 829 patients (413 males, 416 females) were selected and then the left and right images of all patients were acquired; consequently, a total of 1658 temporomandibular joint-related images were evaluated in this study. The degree of CMC was correlated with age in men and women (p < 0.05). The frequency of CMC 0 disappeared in woman aged 20 years and in men aged 21 years. Cortical bone formation of the mandibular condyle was completed at age 22 years in women and 24 years in men. The degrees of cortical bone formation of the mandibular condyle between men and women showed significant differences between the ages of 15−19 and 22 years. This difference can be interpreted as a different mandible growth period between the sexes.
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Affiliation(s)
- Yo-Seob Seo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Hyun-Jeong Park
- Department of Oral Medicine, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Sun-Kyoung Yu
- Department of Oral Anatomy, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Seo-Rin Jeong
- Department of Orthodontics, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Ji-Won Ryu
- Department of Oral Medicine, School of Dentistry, Gwangju 61452, Republic of Korea
- Correspondence:
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Sarlabous M, El-Rabbany M, Caminiti M, Psutka DJ. Alloplastic Temporomandibular Joint Replacement in Patients With Systemic Inflammatory Arthritis and Connective Tissue Disorders. J Oral Maxillofac Surg 2021; 79:2240-2246. [PMID: 34119479 DOI: 10.1016/j.joms.2021.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/17/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE We present a retrospective study to report the outcomes of total temporomandibular joint (TMJ TJR) replacement with alloplastic devices in patients suffering from systemic inflammatory arthropathies. METHODS A total of 39 patients with a diagnosis of rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PA), juvenile idiopathic rheumatoid arthritis (JIA), or systemic lupus, underwent alloplastic total joint replacement(s) (TJR) from 1999 to 2019. Maximal interincisal opening (in mm) was recorded before surgery (T0), at 1-year post-surgery (T1) and at last follow-up (T2). A visual analog scale (from 0 to 10) was used for subjective examination of pain before surgery (T0) and at last follow-up (T2). Comparisons were conducted with statistical significance set at P < .05. RESULTS Seventy-four joints were replaced in 39 patients. Thirty-two were female. The mean age was 36 years old (range 18-61) and the mean follow-up was 45.9 months (SD 49.4). The most common diagnosis was RA (n = 21), followed by JIA (n = 5) and AS (n = 5), PA (n = 4), lupus (n = 3), and mixed connective tissue disorder (n = 1). The mean pain score had fallen from 6.8 (SD 3.2) at T0 to 1.3 (SD 2.4) (P < .001) at T2. The maximal interincisal opening had improved from a mean of 22.1 mm (SD 13.3) at T0 to 34.3 mm (SD 8.5) (P < .001) at T2. One patient got persistent dysesthesia in the V3 distribution. There were no serious late complications. CONCLUSION Patients suffering from systemic inflammatory arthropathies involving the TMJs can be successfully treated by TJR with alloplastic devices. The long-term reduction of TMJ symptoms and functional improvement in this initial study suggest good predictability for this treatment.
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Affiliation(s)
- Mathilde Sarlabous
- Attending Oral and Maxillofacial Surgeon and director, TMJ Surgery Program, Laval University, Quebec City. Canada; Co-founder, Sinai Health System Centre for Excellence in TMJ Surgery.
| | | | - Marco Caminiti
- Assistant professor and Head, University of Toronto Oral and Maxillofacial Surgery Program, Toronto, Canada; Co-director, University of Toronto Fellowship Program in Advanced TMJ and Orthognathic Surgery; Director, University of Toronto Centre for Advanced Jaw Surgery; Chief, Department of Oral and Maxillofacial Surgery, Humber River Regional Hospital, Toronto, Canada
| | - David J Psutka
- Assistant Professor, University of Toronto Department of Oral and Maxillofacial Surgery; Co-founder, Sinai Health System Centre for Excellence in TMJ Surgery; Co-director, University of Toronto Fellow ship Program in Advanced TMJ and Orthognathic Surgery
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Covert L, Mater HV, Hechler BL. Comprehensive Management of Rheumatic Diseases Affecting the Temporomandibular Joint. Diagnostics (Basel) 2021; 11:diagnostics11030409. [PMID: 33673675 PMCID: PMC7997293 DOI: 10.3390/diagnostics11030409] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/18/2022] Open
Abstract
The temporomandibular joint (TMJ) is a synovial joint and thus is vulnerable to the afflictions that may affect other joints in the fields of rheumatology and orthopedics. Too often temporomandibular complaints are seen strictly as dental or orofacial concerns. Similarly, patients with known rheumatic disease may not have their TMJs included in routine screening and monitoring protocols. The purpose of this review is to highlight the rheumatic conditions likely to affect the TMJ and outline medical and surgical management in these patients with a focus on the need for continued patient reassessment and monitoring.
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Affiliation(s)
- Lauren Covert
- Department of Pediatrics, Division of Rheumatology, Duke University Hospitals, Durham, NC 27710, USA; (L.C.); (H.V.M.)
| | - Heather Van Mater
- Department of Pediatrics, Division of Rheumatology, Duke University Hospitals, Durham, NC 27710, USA; (L.C.); (H.V.M.)
| | - Benjamin L. Hechler
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospitals, Durham, NC 27710, USA
- Department of Head and Neck Surgery and Communication Sciences, Duke University Hospitals, Durham, NC 27710, USA
- Correspondence:
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Custom Alloplastic Temporomandibular Joint Reconstruction: Expanding Reconstructive Horizons. J Craniofac Surg 2021; 31:1651-1658. [PMID: 32569038 DOI: 10.1097/scs.0000000000006595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Custom alloplastic temporomandibular joint (TMJ) reconstruction has been well established for the management of end-stage TMJ disease. However, its use in congenital TMJ deformities is limited. Here, the authors present initial outcomes of skeletally mature patients who underwent custom alloplastic TMJ reconstruction and simultaneous orthognathic surgery.A retrospective case series of patients who underwent custom alloplastic TMJ reconstruction concurrent with orthognathic surgery between 2014 and 2019 was completed. Functional, aesthetic and orthodontic outcomes as well as complications were recorded.Seven TMJs in 5 skeletally mature patients (4 female, 1 male, ages 16-30) (2 bilateral, 3 unilateral) were replaced. All but 1 patient had previous attempts at reconstructive surgery with poor results. All cases were prepared using virtual surgical planning and underwent concomitant maxillomandibular orthognathic surgery. All patients demonstrated improved post-operative occlusions. Four of 5 patients achieved >30 millimeters of post-operative MIO. Complications included ear canal perforation and facial nerve dysfunction.There were no infections or other implant-related complications. Mean follow up was 2 years and 15 days. Alloplastic TMJ reconstruction at the time of skeletal maturity for patients with congenital mandibular TMJ defects is an alternative to existing management options. Further long-term prospective outcomes studies are ongoing.
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Klinkhardt C, Tanaka P, Adriano A. Anesthesia for Patients with Juvenile Idiopathic Arthritis Current Practice: A Review. Open Orthop J 2020. [DOI: 10.2174/1874325002014010110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Juvenile Idiopathic Arthritis is one of the most common chronic diseases in children. The disease affects one or multiple joints. Additionally, systemic involvement can be present either due to the condition itself or due to pharmacologic side effects resulting from treatment. This article reviews different aspects of perioperative management of patients with Juvenile Idiopathic Arthritis. It outlines the risks and difficulties secondary to articular damage, and also pharmacologic treatment strategies interfering with the anesthetic plan.
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Pinchi V, Bianchi I, Pradella F, Vitale G, Focardi M, Tonni I, Ferrante L, Bucci A. Dental age estimation in children affected by juvenile rheumatoid arthritis. Int J Legal Med 2020; 135:619-629. [PMID: 32820356 PMCID: PMC7870602 DOI: 10.1007/s00414-020-02395-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/03/2020] [Indexed: 12/19/2022]
Abstract
Abstract Dental root calcification has proven to be a reliable biological evidence to estimate chronological age of children. The development of structures usually examined in the age estimation forensic practice (e.g. skeleton, teeth) is supposed to be influenced by diseases and nutritional, environmental, ethnic, and ultimately even socioeconomic factors. This research aims to study the age estimation in children affected by juvenile rheumatoid arthritis (JRA) with and without steroids treatment and compared with healthy subjects. Material and methods Dental age estimations based on 752 OPGs, 420 girls and 332 boys, aged from 3.3 to 15.99 years, were provided by applying Demirjian and Willems’ original methods. Of the whole sample, 103 individuals were affected by JRA and 40 received a continuous corticosteroid therapy, over 1 year long. Conclusions Willems’ and Demirjian’s original methods, as methods commonly applied to estimate age for sub-adults with unremarkable medical history, can be used for medico-legal purposes to children affected by JRA. Willems’ method tended to underestimate age while Demirjian’s method resulted to be prone to overestimation for both healthy and JRA-affected children. JRA showed to have no influence on root calcification process even in children that received steroid treatment for 1 year or longer. Electronic supplementary material The online version of this article (10.1007/s00414-020-02395-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vilma Pinchi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Ilenia Bianchi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Francesco Pradella
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Giulia Vitale
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Martina Focardi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - Ingrid Tonni
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, P.le Spedali Civili, 25123, Brescia, Italy
| | - Luigi Ferrante
- Center of Epidemiology, Biostatistics and Medical Information Technology, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, 60020, Ancona, Italy.
| | - Andrea Bucci
- Department of Economics, Università degli Studi G. d'Annunzio Chieti-Pescara, Viale Pindaro 42, 65127, Pescara, Italy
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Hawkins A, Mercuri LG, Miloro M. Are Rib Grafts Still Used for Temporomandibular Joint Reconstruction? J Oral Maxillofac Surg 2020; 78:195-202. [DOI: 10.1016/j.joms.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/08/2019] [Accepted: 09/08/2019] [Indexed: 01/05/2023]
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