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Schlabe J, Davies RO, Aagaard E, Cousin G, Edwards AI, McAlister K, Cascarini L. Extended Total Temporomandibular Joint Replacement - A Feasible Option for Functional and Aesthetic Reconstruction of Mandibular Defects Involving the Temporomandibular Joint. Craniomaxillofac Trauma Reconstr 2023; 16:180-194. [PMID: 37975029 PMCID: PMC10638972 DOI: 10.1177/19433875221094971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Study design: Retrospective case series. Objective: Alloplastic temporomandibular joint replacement has been established as a standard technique for end- stage temporomandibular (TMJ) pathologies. Joint replacement when there are extensive mandibular defects remains a challenging clinical problem. Custom-made extended temporomandibular joint replacement is a feasible option but there is limited information about this emerging technique. Methods: Included were all patients undergoing extended TMJ-replacements (TMJe), all operatrions were carried out by the senior author. Surgical technique was either single stage or two stage protocol. Surgical details and pitfalls and outcome of more than 2 years follow-up with reference to thirteen including twelve patients were recorded. Results: The most common diagnosis was ameloblastoma of the mandibular ramus. Single stage or two stagge regime were carried out depending on resection requirements and involvement of teeth. Improved mouth opening of more than 30mm was achieved in 10 of 12 patients. One patient with previous TMJ replacement reported temporary weakness of the facial nerve, which resolved after 10 months. Conclusions: The authors suggest a simplified anatomically based single-stage or two-stage regime, with both regimes achieved excellent anatomic reconstruction, facial appearance and function with low surgical morbidity. Custom-made extended temporomandibular joint protheses appear an advanced and reliable solution for reconstruction of combined complex mandibular defects including the temporomandibular joint. If surgical clearance of the pathology can be achieved, a single-stage regime is favoured.
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Affiliation(s)
- Juergen Schlabe
- Head and Neck Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Rhodri O.H.L. Davies
- Oral- and Maxillofacial Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Esben Aagaard
- Oral- and Maxillofacial Surgery, Odense Universitetshospital, Odense, Europe
| | - Gary Cousin
- Oral- and Maxillofacial Surgery, Royal Blackburn Teaching Hospital, Blackburn, UK
| | | | - Kenneth McAlister
- Oral- and Maxillofacial Surgery, Royal Blackburn Teaching Hospital, Blackburn, UK
| | - Luke Cascarini
- Oral- and Maxillofacial Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Wolford LM, Amaya P, Kesterke M, Pitombeira Pinto L, Franco P. Can Patients With Metal Hypersensitivity Requiring TMJ Total Joint Prostheses be Successfully Treated With All-Titanium Alloy Mandibular Components? J Oral Maxillofac Surg 2021; 80:599-613. [PMID: 34813761 DOI: 10.1016/j.joms.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Patients with documented metal hypersensitivity to cobalt-chromium-molybdenum (CoCrMo) alloy with trace nickel requiring TMJ total joint prosthesis (TJP) may have adverse reactions to the metals in the standard TMJ Concepts TJP. This study aimed to determine if these patients can be successfully treated by eliminating CoCrMo alloy and constructing the mandibular components of all-titanium (Ti) alloy. PATIENTS AND METHODS This retrospective cohort study evaluated metal hypersensitive patients (MHG) that received the TMJ Concepts TJP modification of all-Ti alloy mandibular components with outcome results compared to a control group (CG) of non-metal-sensitive patients that received the standard TMJ Concepts prostheses. The primary predictor variables were the 2 groups, MHG and CG. Primary variables evaluated using Likert scales included TMJ pain, headache, jaw function, diet, and disability. Maximum incisal opening and quality of life were measured. Secondary variables included: age, gender, effect of the number and type of prior TMJ. Scores for pre- and postsurgery parameters (nonparametric variables) were analyzed using a Mann-Whitney U test (α = 0.05). RESULTS The MHG (n = 30) received the Ti alloy TJP and CG (n = 46) received the standard TJP, with statistically significant improvements in all variables in both groups and no statistically significant difference in outcome variables between the 2 groups. Patients with 0 to 1 previous TMJ surgeries had better outcomes in all parameters except maximum incisal opening compared to patients with 2 or more previous TMJ surgeries. CONCLUSIONS Patients with documented hypersensitivity to CoCrMo alloy, requiring TMJ Concepts TJP may experience improvement in TMJ pain, headache, jaw function, diet, disability, jaw opening, and quality of life when the mandibular components are manufactured from all-Ti alloy, eliminating the CoCrMo alloy. The larger the number of previous TMJ surgeries and exposure to failed alloplastic implants, the less improvement in treatment outcomes.
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Affiliation(s)
- Larry M Wolford
- Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University College of Dentistry, Private Practice Baylor University Medical Center, Dallas, TX.
| | - Pilar Amaya
- Resident, Oral and Maxillofacial Surgery, University of Bosque, Bogota, Columbia
| | - Matthew Kesterke
- Assistant Professor, Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX
| | - Lecio Pitombeira Pinto
- Chairman, Department of Oral and Maxillofacial Surgery, Fortaleza General Hospital, Fortaleza, Ceará, Brazil
| | - Pedro Franco
- Part-time Teaching Faculty, Texas A&M University College of Dentistry, Dallas, TX; Private practice, Irving, TX
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Jaafar A, Hecker C, Árki P, Joseph Y. Sol-Gel Derived Hydroxyapatite Coatings for Titanium Implants: A Review. Bioengineering (Basel) 2020; 7:bioengineering7040127. [PMID: 33066421 PMCID: PMC7711523 DOI: 10.3390/bioengineering7040127] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/05/2020] [Accepted: 10/10/2020] [Indexed: 01/02/2023] Open
Abstract
With the growing demands for bone implant therapy, titanium (Ti) and its alloys are considered as appropriate choices for the load-bearing bone implant substitutes. However, the interaction of bare Ti-based implants with the tissues is critical to the success of the implants for long-term stability. Thus, surface modifications of Ti implants with biocompatible hydroxyapatite (HAp) coatings before implantation is important and gained interest. Sol-gel is a potential technique for deposition the biocompatible HAp and has many advantages over other methods. Therefore, this review strives to provide widespread overview on the recent development of sol-gel HAp deposition on Ti. This study shows that sol-gel technique was able to produce uniform and homogenous HAp coatings and identified the role of surface pretreatment of Ti substrate, optimizing the sol-gel parameters, substitution, and reinforcement of HAp on improving the coating properties. Critical factors that influence on the characteristics of the deposited sol-gel HAp films as corrosion resistance, adhesion to substrate, bioactivity, morphological, and structural properties are discussed. The review also highlights the critical issues, the most significant challenges, and the areas requiring further research.
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Roychoudhury A, Yadav P, Alagarsamy R, Bhutia O, Goswami D. Outcome of Stock Total Joint Replacement With Fat Grafting in Adult Temporomandibular Joint Ankylosis Patients. J Oral Maxillofac Surg 2020; 79:75-87. [PMID: 32866483 DOI: 10.1016/j.joms.2020.07.214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/04/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Adult temporomandibular joint ankylosis (TMJA) lacks a uniform management protocol. The purpose of the study was to evaluate the outcome of stock total joint replacement (TJR) along with fat grafting around the joint in adult TMJA patients. Specific aim was to find out whether TJR can be a definitive management for adult TMJA. METHODS The investigators implemented a prospective study on adult TMJA patients treated with ostearthrectomy of ankylosis and stock temporomandibular joint (TMJ) TJR with fat grafting. Concomitant orthognathic correction of facial asymmetry was performed in some unilateral cases. Follow-up was carried out at regular intervals for assessing primary outcome variable of maximal incisal opening (MIO) and reankylosis. Secondary outcome variable included demographic data, etiology, duration of ankylosis (DOA), correlation between DOA and preoperative and postoperative MIO, occlusion and complications of hemorrhage, facial nerve paresis, periprosthetic joint infection, dislocation, and implant failure. RESULTS The study sample was composed of 41 patients (54 joints) (bilateral, n = 13; unilateral, n = 28 [right side, n = 12; left side, n = 16]). The number of recurrent cases was 15. Trauma as etiology of ankylosis was seen in n = 30 (73.2%), infection in n = 7 (17.1%), unknown in n = 3 (7.3%), and ankylosing spondylitis in n = 1 (2.4%) cases. Mean DOA was 11.95 years. Paired t test revealed a statistically significant difference between preoperative and follow-up MIO (P < .001). None of the cases showed reankylosis in the follow-up period. Pearson correlation revealed statistically negative correlation between DOA and postoperative MIO. CONCLUSIONS The result of this study suggests that stock TMJ TJR along with fat grafting around the joints provides adequate mouth opening without any sign and symptoms of reankylosis. Stock TMJ TJR with fat grafting can be considered as a definitive treatment modality in adult TMJA with minimum comorbidity.
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Affiliation(s)
- Ajoy Roychoudhury
- Professor and Head, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Poonam Yadav
- Scientist, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ragavi Alagarsamy
- Junior Resident, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ongkila Bhutia
- Professor, Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Devalina Goswami
- Additional Professor, Department of Anesthesiology, Pain Medicine & Critical Care, All India Institute of Medical Sciences, New Delhi, India
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Ankha MDVEA, Silva ADM, Prado RFD, Camalionte MP, Vasconcellos LMRD, Radi PA, Silva Sobrinho ASD, Vieira L, Carvalho YR. Effect of DLC Films with and without Silver Nanoparticles Deposited On Titanium Alloy. Braz Dent J 2019; 30:607-616. [DOI: 10.1590/0103-6440201902708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/24/2019] [Indexed: 11/22/2022] Open
Abstract
Abstract Diamond-like carbon (DLC) film is a biocompatible hard coating material that can prevent the leaching of metal ions. This study evaluates the structural characteristics of DLC, with and without silver nanoparticles, deposited by plasma (PECVD) on titanium alloy (Ti-6Al-4V) and bone formation in contact with DLC films. Sixty Ti-6Al-4V samples were used divided in: uncoated, coated with DLC and coated with DLC-Ag. After structural characterization, samples were fixed bilaterally at the rabbit's mandible. After 15 and 90 days, samples were characterized again and bone formation in the area was analyzed by histomorphometry. Statistical analysis was performed by two-way ANOVA. Both the DLC and DLC-Ag films were firmly adhered and showed a high electrical resistance without significant changes in the Raman spectrum after in vivo integration. After 15 days, there were immature bone trabeculae in the interface and partially covering the surface. After 90 days, mature bone filled the interface and coved the surface. There was no statistically significant difference among the three groups in both periods. In conclusion, osseointegration with DLC, DLC-Ag and uncoated Ti-6Al-4V is similar. However, DLC and DLC-Ag coverings have the advantage of electrical insulation and can presumably control bacterial activity and ion leaching.
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Affiliation(s)
| | | | | | | | | | - Polyana Alves Radi
- Universidade Estadual Paulista, Brazil; Universidade do Vale do Paraíba, Brazil
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Henry A, Inverso G, Granquist EJ. Revision temporomandibular joint arthroplasty for the treatment of acquired metal allergy and review of the literature. Int J Oral Maxillofac Surg 2019; 49:356-360. [PMID: 31447220 DOI: 10.1016/j.ijom.2019.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 08/04/2019] [Accepted: 08/06/2019] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to examine the outcomes of patients who received revision temporomandibular joint (TMJ) arthroplasty for the treatment of acquired metal allergy. It was hypothesized that subjects would have significant improvements in pain, swelling, and function. Patients who underwent TMJ revision due to nickel allergy were identified retrospectively. Outcomes documented included the presence or absence of facial erythema and facial swelling. Maximum incisal opening was also measured. Additional outcomes collected included age at initial surgery, initial TMJ device type, presenting symptoms, and TMJ device used for surgical revision. Four patients were identified with a nickel allergy to their TMJ prosthesis (containing nickel). All subjects experienced pain and swelling as their primary symptoms prior to the revision, with two subjects showing dermatological symptoms of overlying erythema. The four female subjects underwent exchange of their previously implanted prosthesis with a titanium alloy prosthesis. Postoperatively, all subjects showed improvements in pain score, resolution of swelling and erythema, and improvements in maximum incisal opening. This small case series suggests that revision TMJ arthroplasty with a titanium alloy prosthesis is a potential treatment for acquired metal allergy from traditional TMJ prosthesis implantation.
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Affiliation(s)
- A Henry
- Carolinas Center for Oral and Maxillofacial Surgery, Charlotte, NC, USA
| | - G Inverso
- Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - E J Granquist
- Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Aguilera-Correa JJ, Auñón Á, Boiza-Sánchez M, Mahillo-Fernández I, Mediero A, Eguibar-Blázquez D, Conde A, Arenas MÁ, de-Damborenea JJ, Cordero-Ampuero J, Esteban J. Urine Aluminum Concentration as a Possible Implant Biomarker of Pseudomonas aeruginosa Infection Using a Fluorine- and Phosphorus-Doped Ti-6Al-4V Alloy with Osseointegration Capacity. ACS OMEGA 2019; 4:11815-11823. [PMID: 31460290 PMCID: PMC6682075 DOI: 10.1021/acsomega.9b00898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Joint prosthesis failure is mainly related to aseptic loosening and prosthetic joint infections, both associated with high morbidity and a substantial cost burden for patients and health systems. The development of a biomaterial capable of stimulating bone growth while minimizing bacterial adhesion would reduce the incidence of prosthetic failure. Using an in vivo rabbit model, this study evaluates the osseointegration effect of the fluorine (F)- and phosphorus (P)-doped bottle-shaped nanostructured (bNT) Ti-6Al-4V alloy and effectiveness of monitoring urine aluminum concentration to determine the presence of Pseudomonas aeruginosa infection in Ti-6Al-4V implants. Unlike chemically polished (CP) Ti-6Al-4V alloy implants, bNT Ti-6Al-4V alloy implants promoted osseointegration and showed effectiveness as a biomaterial marker. The bNT Ti-6Al-4V alloy implants were associated with a twofold increase in bone thickness and up to 15% greater bone density compared to the CP alloy. Additionally, bNT Ti-6Al-4V alloy implants allowed for discrimination between P. aeruginosa-infected and noninfected animals for 15 days postoperatively, as indicated by the decrease of aluminum concentration in urine, while this difference was only appreciable over the first 7 days when CP Ti-6Al-4V alloy implants were used. Therefore, bNT Ti-6Al-4V alloys could have clinical applications by detecting the infection and by avoiding aseptic loosening.
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Affiliation(s)
- John-Jairo Aguilera-Correa
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Álvaro Auñón
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Macarena Boiza-Sánchez
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Ignacio Mahillo-Fernández
- Orthopedic Surgery Service, Pathology Department, and Epidemiology
and Biostatistics
Service, Fundación Jiménez
Díaz University Hospital, Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Aranzazu Mediero
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Diego Eguibar-Blázquez
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
| | - Ana Conde
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - María-Ángeles Arenas
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - Juan-José de-Damborenea
- Corrosion
and Material Protection Group, National
Center for Metallurgical Research (CENIM-CSIC), Av. Gregorio del Amo, 8, 28040 Madrid, Spain
| | - José Cordero-Ampuero
- Department
of Orthopaedic Surgery, University Hospital
La Princesa, c/Diego de León 62, 28006 Madrid, Spain
| | - Jaime Esteban
- Clinical Microbiology Department, Joint and Bone Research Unit,
and Experimental Surgery and
Animal Research Service, IIS-Fundación
Jimenez Diaz, UAM. Av. Reyes Católicos, 2, 28040 Madrid, Spain
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Donahue RP, Gonzalez-Leon EA, Hu JC, Athanasiou KA. Considerations for translation of tissue engineered fibrocartilage from bench to bedside. J Biomech Eng 2018; 141:2718210. [PMID: 30516244 PMCID: PMC6611470 DOI: 10.1115/1.4042201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/27/2018] [Indexed: 12/25/2022]
Abstract
Fibrocartilage is found in the knee meniscus, the temporomandibular joint (TMJ) disc, the pubic symphysis, the annulus fibrosus of intervertebral disc, tendons, and ligaments. These tissues are notoriously difficult to repair due to their avascularity, and limited clinical repair and replacement options exist. Tissue engineering has been proposed as a route to repair and replace fibrocartilages. Using the knee meniscus and TMJ disc as examples, this review describes how fibrocartilages can be engineered toward translation to clinical use. Presented are fibrocartilage anatomy, function, epidemiology, pathology, and current clinical treatments because they inform design criteria for tissue engineered fibrocartilages. Methods for how native tissues are characterized histomorphologically, biochemically, and mechanically to set gold standards are described. Then, provided is a review of fibrocartilage-specific tissue engineering strategies, including the selection of cell sources, scaffold or scaffold-free methods, and biochemical and mechanical stimuli. In closing, the Food and Drug Administration paradigm is discussed to inform researchers of both the guidance that exists and the questions that remain to be answered with regard to bringing a tissue engineered fibrocartilage product to the clinic.
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Affiliation(s)
- Ryan P. Donahue
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Erik A. Gonzalez-Leon
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Jerry C. Hu
- Department of Biomedical Engineering,
University of California, Irvine,
Irvine, CA 92697
e-mail:
| | - Kyriacos A. Athanasiou
- Fellow ASME
Department of Biomedical Engineering,
University of California, Irvine
Irvine, CA 92697
e-mail:
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De Meurechy N, Mommaerts M. Alloplastic temporomandibular joint replacement systems: a systematic review of their history. Int J Oral Maxillofac Surg 2018; 47:743-754. [DOI: 10.1016/j.ijom.2018.01.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/07/2017] [Accepted: 01/22/2018] [Indexed: 12/16/2022]
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De Meurechy N, Braem A, Mommaerts M. Biomaterials in temporomandibular joint replacement: current status and future perspectives—a narrative review. Int J Oral Maxillofac Surg 2018; 47:518-533. [DOI: 10.1016/j.ijom.2017.10.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/09/2017] [Accepted: 10/02/2017] [Indexed: 12/31/2022]
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Abstract
PURPOSE OF REVIEW Temporomandibular joint (TMJ) reconstruction represents one of the more challenging clinical problems that a head and neck surgeon encounters. Fortunately, the problem is fairly uncommon; however, at the same time, clear clinical guidelines have not been formulated. The goal of this review is to present the established solutions to this difficult reconstructive challenge and highlight key developments that have been recently published. RECENT FINDINGS Modern-day approaches to TMJ reconstruction include a handful of surgical modalities: costochondral grafting, revascularized tissue transfer, distraction osteogenesis, and alloplastic temporomandibular joint replacement (APTMJR). Over the past several years, publications have focused primarily on distraction osteogenesis and APTMJR. In particular, APTMJR is emerging as a highly successful and versatile surgical modality when faced with TMJ defects. SUMMARY With long-term follow-up after APTMJR approaching 20 years at several of the pioneering centers, alloplastic total joint replacement is emerging as the clinical standard when faced with TMJ defects in a variety of clinical situations. Unfortunately, the dogma of serious complications that occurred during early development may still be stalling widespread acceptance of APTMJR. Due to the complexity of the surgery, its relative infrequency and the lack of exposure in the majority of residency training programs, this surgery is currently best performed by tertiary referral centers.
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Aagaard E, Thygesen T. A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis. Int J Oral Maxillofac Surg 2014; 43:1229-35. [DOI: 10.1016/j.ijom.2014.05.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/19/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
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Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants 2014; 28:e393-414. [PMID: 24278954 DOI: 10.11607/jomi.te20] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up to 25% of the population, but their etiology and progression are poorly understood and, as a result, treatment options are limited. In up to 70% of cases, TMD are accompanied by malpositioning of the temporomandibular joint (TMJ) disc, termed "internal derangement." Although the onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Because of the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient's disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches that can restore joint functionality while responding to changes in the joint have become a necessity. One such approach, tissue engineering, which may be capable of integration and adaptation in the TMJ, carries significant potential for the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. An analysis of native tissue characterization to assist clinicians in identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ is followed by a discussion of current trends in tissue engineering.
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Neelakandan RS, Raja AVDK, Krishnan AM. Total Alloplastic Temporomandibular Joint Reconstruction for Management of TMJ Ankylosis. J Maxillofac Oral Surg 2013. [PMID: 26225031 DOI: 10.1007/s12663-013-0565-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Temporomandibular joint (TMJ) ankylosis involves the fusion of the mandibular condyle to the glenoid fossa, the skull base. The dilemma with regards to treatment planning whether distraction is done before gap arthroplasty or as a simultaneous procedure or after gap arthroplasty is still a controversy. In an attempt to carry out both the procedures simultaneously there is loss of vector control of the distal segment and the risk of pseudoarthrosis at the osteotomy site. This combined problem could be overcome by the use of total alloplastic joint prosthesis which offers a firm posterior stop for the proximal segment and negates aggressive physiotherapy. MATERIAL AND METHODS The reference literatures were retrieved from Pub Med and Science Direct database. Three case reports of bilateral recurrent TMJ ankylosis successfully treated with custom made total TMJ by the authors are illustrated. CONCLUSION The purpose of this article is to review the world literature on various alloplastic joints available for TMJ reconstruction and to introduce our indigenous total joint prosthesis in the management of recurrent ankylosis.
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Affiliation(s)
- R S Neelakandan
- Meenakshiammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
| | - A V Dharmesh Kumar Raja
- Meenakshiammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India ; 46, P.S.K. Nagar, Rajapalayam, 626108 Tamil Nadu India
| | - Arun M Krishnan
- Meenakshiammal Dental College and Hospital, Maduravoyal, Chennai, 600095 India
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Leandro LL, Ono H, de Souza Loureiro C, Marinho K, Garcia Guevara H. A ten-year experience and follow-up of three hundred patients fitted with the Biomet/Lorenz Microfixation TMJ replacement system. Int J Oral Maxillofac Surg 2013; 42:1007-13. [PMID: 23769150 DOI: 10.1016/j.ijom.2013.04.018] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 04/21/2013] [Accepted: 04/23/2013] [Indexed: 11/25/2022]
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Hussain OT, Sah S, Sidebottom AJ. Prospective comparison study of one-year outcomes for all titanium total temporomandibular joint replacements in patients allergic to metal and cobalt-chromium replacement joints in patients not allergic to metal. Br J Oral Maxillofac Surg 2013; 52:34-7. [PMID: 23522619 DOI: 10.1016/j.bjoms.2013.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 02/04/2013] [Indexed: 11/16/2022]
Abstract
We aimed to ascertain whether there are any early differences in outcome between all titanium temporomandibular joint (TMJ) prostheses in patients allergic to metal and standard cobalt-chromium prostheses in patients not allergic to metal. All patients who had primary TMJ prostheses placed with one-year follow-up between March 2003 and February 2011 were included. We reviewed the basic characteristics of patients. The outcome variables measured included disease, pain, mouth opening, and diet. A total of 55 patients with 77 joint replacements fulfilled the inclusion criteria. Forty patients had standard cobalt-chromium alloy (Co-Cr-Mo) prostheses (20 unilateral and 20 bilateral), and 15 had all titanium prostheses (13 unilateral and 2 bilateral). Osteoarthritis was the most common disease in both groups. There was significant improvement in pain score at reviews at 6 weeks (p=0.001) and 12 months (p=0.03). Values between groups were not significant (p=0.48 at 6 weeks, and p=0.10 at 1 year). Mouth opening in each group improved significantly with continued gains between assessments at 6 weeks and 12 months (p=0.001) but there were no significant differences between groups. Diet scores were significantly improved one year postoperatively in both groups (p=0.001), but differences between groups were not significant (p=0.90). At one year, outcomes for all titanium prostheses in patients allergic to metal were similarly favourable to those in patients who had no hypersensitivity to metal and had standard prostheses. No patient developed a hypersensitivity reaction, and no all titanium prosthesis failed during the one-year follow-up period.
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Affiliation(s)
- O T Hussain
- Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom.
| | - S Sah
- Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom.
| | - A J Sidebottom
- Queens Medical Centre, Nottingham University Hospitals, England, Oral and Maxillofacial Surgery Department, Derby Road, Nottingham NG7 2UH, United Kingdom.
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17
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Murphy MK, Huey DJ, Reimer AJ, Hu JC, Athanasiou KA. Enhancing post-expansion chondrogenic potential of costochondral cells in self-assembled neocartilage. PLoS One 2013; 8:e56983. [PMID: 23437288 PMCID: PMC3578801 DOI: 10.1371/journal.pone.0056983] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 01/16/2013] [Indexed: 11/18/2022] Open
Abstract
The insufficient healing capacity of articular cartilage necessitates mechanically functional biologic tissue replacements. Using cells to form biomimetic cartilage implants is met with the challenges of cell scarcity and donor site morbidity, requiring expanded cells that possess the ability to generate robust neocartilage. To address this, this study assesses the effects of expansion medium supplementation (bFGF, TFP, FBS) and self-assembled construct seeding density (2, 3, 4 million cells/5 mm dia. construct) on the ability of costochondral cells to generate biochemically and biomechanically robust neocartilage. Results show TFP (1 ng/mL TGF-β1, 5 ng/mL bFGF, 10 ng/mL PDGF) supplementation of serum-free chondrogenic expansion medium enhances the post-expansion chondrogenic potential of costochondral cells, evidenced by increased glycosaminoglycan content, decreased type I/II collagen ratio, and enhanced compressive properties. Low density (2 million cells/construct) enhances matrix synthesis and tensile and compressive mechanical properties. Combined, TFP and Low density interact to further enhance construct properties. That is, with TFP, Low density increases type II collagen content by over 100%, tensile stiffness by over 300%, and compressive moduli by over 140%, compared with High density. In conclusion, the interaction of TFP and Low density seeding enhances construct material properties, allowing for a mechanically functional, biomimetic cartilage to be formed using clinically relevant costochondral cells.
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Affiliation(s)
- Meghan K. Murphy
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Daniel J. Huey
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Andrew J. Reimer
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Jerry C. Hu
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Kyriacos A. Athanasiou
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
- * E-mail:
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18
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Martin F, Lehmann M, Anderer U. Generation of Scaffold Free 3-D Cartilage-Like Microtissues from Human Chondrocytes. ACTA ACUST UNITED AC 2013. [DOI: 10.4018/978-1-4666-2506-8.ch008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Since our society is characterized by an increasing age of its people on the one hand and a high number of persons dealing with sports on the other hand, the number of patients suffering from traumatic defects or osteoarthritis is growing. In combination with the articular cartilage specific limited capacity to regenerate, a need for suitable therapies is obvious. Thereby, cell-based therapies are of major interest. This type of clinical intervention was introduced to patients at the beginning of the 1990s. During the last years, a technological shift from simple cell suspensions to more complex 3D structures was performed. In order to optimize the scaffold free generation of cartilage, such as microtissues from human chondrocytes, the authors examine the influence of a static or spinner flask culture with respect to differentiation and architecture of the engineered microtissues. Additionally, the impact of the soluble factors TGF-ß2 and ascorbic acid on this process are investigated. The results demonstrate a positive impact of TGF-ß2 and ascorbic acid supplementation with respect to general Type II Collagen and proteoglycan expression for both the static and spinner flask culture.
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Affiliation(s)
- Frank Martin
- Lausitz University of Applied Sciences (LUAS), Germany
| | - Mario Lehmann
- Lausitz University of Applied Sciences (LUAS), Germany
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19
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Mesnard M, Ramos A. Towards a Rigorous Approach to Designing a TemporoMandibular Joint Prosthesis. From Clinical Challenge to Numerical Prototype. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.procir.2013.01.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Affiliation(s)
- R H B Jones
- James Cook University, Townsville Hospital, Australia.
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21
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Chandran R, Keeler GD, Christensen AM, Weimer KA, Caloss R. Application of Virtual Surgical Planning for Total Joint Reconstruction With a Stock Alloplast System. J Oral Maxillofac Surg 2011; 69:285-94. [DOI: 10.1016/j.joms.2010.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 02/03/2010] [Accepted: 03/04/2010] [Indexed: 11/15/2022]
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22
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Westermark A, Leiggener C, Aagaard E, Lindskog S. Histological findings in soft tissues around temporomandibular joint prostheses after up to eight years of function. Int J Oral Maxillofac Surg 2011; 40:18-25. [PMID: 21044827 DOI: 10.1016/j.ijom.2010.09.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 09/13/2010] [Indexed: 11/30/2022]
Affiliation(s)
- A Westermark
- Department of Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.
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23
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Wolford LM, Rodrigues DB, McPhillips A. Management of the Infected Temporomandibular Joint Total Joint Prosthesis. J Oral Maxillofac Surg 2010; 68:2810-23. [DOI: 10.1016/j.joms.2010.05.089] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 05/01/2010] [Accepted: 05/06/2010] [Indexed: 10/19/2022]
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