1
|
Zheng J, Huo L, Jiao Z, Wei X, Bu L, Jiang W, Luo Y, Chen M, Yang C. 3D-printed temporomandibular joint-mandible combined prosthesis: A prospective study. Oral Dis 2024; 30:1360-1366. [PMID: 37246472 DOI: 10.1111/odi.14597] [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] [Received: 08/22/2022] [Revised: 04/10/2023] [Accepted: 04/15/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The study aimed to introduce and evaluate a new customized temporomandibular joint-mandible combined prosthesis with 3D printing fabrication. MATERIALS AND METHODS This was a prospective study including patients with temporomandibular joint-mandible combined lesions. A 3D-printed customized temporomandibular joint-mandible combined prosthesis was implanted to repair the joint and jaw defect. Clinical follow-up and radiographic examinations were taken to assess the clinical efficacy. The assessment indices were compared by the Wilcoxon signed rank test. RESULTS Eight patients were treated with the combined prosthesis and included in this study. All prostheses were accurately positioned and fixed without wound infection, prosthesis exposure, displacement, loosening, or fracture. All cases had no mass recurrence at the last follow-up point. Pain, diet, mandibular function, lateral mandibular movement to the diseased side, and maximal interincisal opening showed significant improvements at every follow-up point and went to a stable condition at 6 months after the operation. But the lateral movement to the non-operated side was still limited following surgery. CONCLUSION The 3D-printed combined prosthesis may be an alternative to other well-established reconstructions for temporomandibular joint and mandible defects.
Collapse
Affiliation(s)
- Jisi Zheng
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Liang Huo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Zixian Jiao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Xiang Wei
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Lingtong Bu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Wenbo Jiang
- Center of 3D-printing translational medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Minjie Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| |
Collapse
|
2
|
Wang L, Wang Y, Sun X, Chen K, Pang W, Gao Y, Zhu Z, Wu G. A Novel Technique for Resection and Reconstruction of the Temporomandibular Joint by Sliding Vertical Ramus Osteotomy using Only Submandibular Approach. J Craniofac Surg 2023; 34:2163-2167. [PMID: 37291710 DOI: 10.1097/scs.0000000000009408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 06/10/2023] Open
Abstract
In this paper, an innovative technique for resection and reconstruction of the temporomandibular joint by sliding vertical ramus osteotomy using only a submandibular approach is presented. Before pulling the posterior mandibular border slightly downward to expose parts of the condyle, the vertical ramus osteotomy was performed. With the help of 3D simulation and surgical templates, the condylectomy was carried out using the ultrasonic osteotome through the submandibular approach. Our technique achieved the desired results while preventing complications of facial nerve paralysis, the occurrence of Frey syndrome, and the preauricular scar. Therefore, we suggest that this surgical method represents an alternative treatment option for temporomandibular joint lesions.
Collapse
Affiliation(s)
- Lin Wang
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Yingtong Wang
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Xiumei Sun
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun, Jilin, China
| | - Kai Chen
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Wanyu Pang
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Yisu Gao
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Zihe Zhu
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| | - Guomin Wu
- Department of Oral, Plastic and Esthetic Surgery, Hospital of Stomatology, Jilin University, No.1500 Qinghua Road, Changchun, Jilin, China
| |
Collapse
|
3
|
Amarista FJ, Perez DE. Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery. Diagnostics (Basel) 2023; 13:2486. [PMID: 37568850 PMCID: PMC10416914 DOI: 10.3390/diagnostics13152486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
The treatment of patients with severe temporomandibular joint (TMJ) disorders and associated skeletal discrepancies presents a complex challenge for oral and maxillofacial surgeons. It is widely recognized that TMDs can impact the stability and outcomes of surgical treatments for dentofacial deformities. Consequently, addressing TMDs prior to or in conjunction with orthodontic or surgical interventions may be necessary to achieve optimal and long-lasting results. Alloplastic temporomandibular joint replacement (TMJR) and orthognathic surgery have emerged as the standard approach due to their predictability, long-term stability and excellent outcomes when addressing end-stage TMJ disease in conjunction with DFDs as it provides a comprehensive solution to address both functional and aesthetic aspects of these patients' conditions. Understanding the appropriate utilization of TMJR in conjunction with orthognathic surgery can lead to improved treatment planning and successful outcomes for patients with complex TMJ disorders and associated dentofacial deformities. This review aims to discuss the indications, preoperative evaluation, staging, sequencing, and surgical considerations involved in utilizing alloplastic TMJ replacement in the presence of dentofacial deformities.
Collapse
Affiliation(s)
- Felix Jose Amarista
- Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, 8210 Floyd Curl Drive, Mail Code 8124, San Antonio, TX 78229, USA;
| | | |
Collapse
|
4
|
Zheng JS, Jiao ZX, Wei X, Chen MJ, Ahmed A, Yang C. Accuracy of digital templates for guidance of custom-made total temporomandibular joint replacement. Int J Oral Maxillofac Surg 2022; 51:1330-1336. [DOI: 10.1016/j.ijom.2022.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 10/20/2021] [Accepted: 01/05/2022] [Indexed: 11/25/2022]
|
5
|
Perez DE, Wandell A, Jones JP, Amarista FJ. A Minimally Invasive Approach for Temporomandibular Joint Replacement: A Pilot Study. J Oral Maxillofac Surg 2021; 80:256-265. [PMID: 34453907 DOI: 10.1016/j.joms.2021.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
Temporomandibular joint replacement (TJR) with an alloplastic (metal/ultra-high-molecular-weight polyethylene) device has proven to be a successful and predictable procedure. This paper describes a novel technique for performing TJR with an endaural incision alone. The technique we are describing uses only an endaural incision with supplemental trocar incision(s), to perform a TJR. There were 4 patients for a total of 8 temporomandibular joints that were selected. All 4 patients were assessed immediately following surgery, on postoperative days 1 and 7 and at 6 months following surgery. Maximal interincisal opening and subjective variables were assessed at each of the time points. Additionally, the total operative time was measured and compared to a previous age and diagnosis matched control group using the traditional 2 incisions TJR.There were 3 females and 1 male (ages 19-67) who underwent TJR with an endaural incision alone. There were 4 females (ages 19-68) who underwent traditional TJR surgery. None of the patients in either group had major complications and all patients were discharged on postoperative day 1. All patients in the endaural incision alone group had increased maximal interincisal opening and reported a quicker subjective decrease in pain and disability following surgery with less average time in the operating room. However, all patients in the endaural incision alone group had CN VII weakness that lasted longer than those in the traditional TJR group.The minimally invasive approach for TJR was successful in the present pilot study and could be used in specific situations to decrease the morbidity associated with additional incisions for this procedure. Ultimately, the endaural only incision approach offers promising outcomes for future patients undergoing temporomandibular joints TJR in the right patient population.
Collapse
Affiliation(s)
- Daniel E Perez
- Associate Professor and Program Director, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX.
| | - Adam Wandell
- Resident, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Jason P Jones
- Resident, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Felix Jose Amarista
- Assistant Professor, Department of Oral and Maxillofacial Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX
| |
Collapse
|