1
|
Khattak YR, Ghaffar N, Gulzar MA, Rahim S, Rafique F, Jan Z, Iqbal S, Ahmad I. Can growing patients with end-stage TMJ pathology be successfully treated with alloplastic temporomandibular joint reconstruction? - A systematic review. Oral Maxillofac Surg 2024; 28:529-537. [PMID: 37733214 DOI: 10.1007/s10006-023-01180-4] [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: 03/07/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION The use of alloplastic total temporomandibular joint reconstruction (TMJR) in growing patients is controversial, mainly due to immature elements of the craniomaxillofacial skeleton. The aim of this systematic review was to evaluate the use of alloplastic TMJR in growing patients, focusing on the patient's clinical presentation, surgical and medical history and efficacy of alloplastic TMJR implantation. MATERIALS AND METHODS The literature search strategy was based on the Population, Intervention, Comparator, Outcomes and Study type (PICOS) framework. We searched Pubmed, Google Scholar, Dimension, Web of Science, X-mol, Semantic Scholar and Embase to January 2023, without any restriction on the type of publication reporting alloplastic TMJR in growing patients (age ≤ 18 years for boys and age ≤ 15 years for girls). RESULTS A total of 15 studies (case reports: 09, case series: 02, cohort studies: 04) met the inclusion criteria, documenting 73 patients of growing age from 07 countries. Thirty-eight (~ 52%) cases were female. The mean ± SD (range) age and follow-up of patients in all studies was 13.1 ± 3.2 (0-17) years and 34.3 ± 21.5 (7-96) months, respectively. A total of 22 (30%) patients were implanted with bilateral alloplastic TMJR. Over half of the studies (n = 10) were published in the last 3 years. All patients underwent multiple surgeries prior to implantation of alloplastic TMJR. In extreme cases, patients underwent a total of 17 surgeries. Different types of studies reporting inconsistent variables restricted our ability to perform quality assessment measures for evidence building. CONCLUSIONS Clinical experience with alloplastic TMJR in growing patients is limited to cases showing poor prognosis with other types of reconstruction. Nevertheless, studies show promising results for the use of alloplastic TMJR in growing patients, highlighting the need for well-controlled prospective studies with long-term follow-up.
Collapse
Affiliation(s)
| | | | | | - Sundas Rahim
- Peshawar Medical and Dental College, Peshawar, Pakistan
| | | | - Zainab Jan
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
| | - Shaheen Iqbal
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan
| | - Iftikhar Ahmad
- Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan.
| |
Collapse
|
2
|
Wang Y, Li B, Liao J, Wang Y. Comparison of condylar position after free fibular flap mandibular reconstruction using computer-assisted and traditional techniques. BMC Oral Health 2024; 24:452. [PMID: 38622579 PMCID: PMC11017485 DOI: 10.1186/s12903-024-04203-y] [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: 01/17/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVES To compare the changes in condylar position after mandibular reconstruction with free fibular flap(FFF) and the differences between computer-assisted techniques and traditional methods on CT images. METHODS Thirty-four patients who underwent mandibular reconstruction with free fibular flap were selected according to the inclusion and exclusion criteria. In the 3D group, virtual surgical planning (VSP) with osteotomy cutting plate and placement guiding plate were used, while the traditional group underwent freehand reconstruction. The CT data of 68 temporomandibular joints (TMJs) were recorded before and immediately after surgery. The condylar position was evaluated by measuring the anterior space (AS), posterior space (PS) and superior space (SS), and the ln (PS/AS) was calculated according to the method proposed by Pullinger and Hollender. RESULTS In the patients included in the 3D group, the condyle on the ipsilateral side moved slightly backward; however, in the patients in the traditional group, the ipsilateral side moved considerably anteroinferior. No obvious changes on the contralateral side were noted. In the 3D group, 33% of ipsilateral condyles were in the posterior position postoperatively when compared with the preoperative position (13%). In the traditional group, the number of ipsilateral condyles in the anterior position increased from 4 to 10, accounting for 53% postoperatively. Contrary to the traditional group, the 3D group presented less condylar displacement on the ipsilateral side postoperatively. CONCLUSIONS This study showed a decreased percentage of change in condylar position postoperatively when VSP was used. Virtual surgical planning improved the accuracy of FFF mandibular reconstruction and made the condylar position more stable.
Collapse
Affiliation(s)
- Yu Wang
- Department of Orthodontics, Stomatology Hospital of Guangzhou Medical University, 59th Huangsha Road, Guangzhou, Guangdong, 510120, China
| | - Bowen Li
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107th Yanjiang Xi Road, Guangzhou, Guangdong, 510120, China
| | - Juankun Liao
- Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107th Yanjiang Xi Road, Guangzhou, Guangdong, 510120, China
| | - Yan Wang
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107th Yanjiang Xi Road, Guangzhou, Guangdong, 510120, China.
| |
Collapse
|
3
|
Zhang Y, Zheng J, Wu Q, Jiang T, Xiao H, Du Y, Qi Y, Jin Z, Li F. Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner. Head Face Med 2024; 20:4. [PMID: 38184631 PMCID: PMC10770962 DOI: 10.1186/s13005-023-00404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Our study aimed to use three-dimensional (3D) spatial morphological measurement methods to compare the influence of Twin-Block and clear functional aligners on the temporomandibular joint (TMJ) of adolescent Class II division 1 malocclusion mandibular retraction patients. We also aimed to explore the similarities and differences in the effects on the TMJ upon using Twin-Block and clear functional aligner. METHODS Cone-beam computed tomography (CBCT) data of 49 patients with Class II division 1 malocclusion (Twin-Block group: 24; clear functional aligner group: 25) were collected before and after functional orthodontic treatment, and a 3D model of the TMJ was reconstructed using MIMICS 21.0 software. Eighteen measurement parameters, including the anterior, superior, and posterior joint spaces, were measured and compared using the 3D model. RESULTS After the two groups underwent functional appliance treatment, the height, volume, and surface area of the condyle, length of the mandibular ramus and mandibular length increased; The retro-displaced condyle moved to the middle position of the articular fossa, while the rest of the condylar position did not change significantly. Remodeling of the articular fossa after treatment was not evident. The superior joint space of the clear functional aligner group increased, but there was no significant change after Twin-Block appliances treatment. CONCLUSIONS Both appliances promote condylar growth and sagittal and vertical development of the mandible in adolescent Class II division 1 malocclusion mandibular retraction patients. The length of the mandibular ramus showed a more significant increase following treatment with the Twin-Block appliances than with clear function aligners.
Collapse
Affiliation(s)
- Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yizhe Qi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Zuolin Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| |
Collapse
|