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At least 919 records · Page 51Linked to original sources
PubMed2004

Surgical management of advanced degenerative arthritis of temporomandibular joint with metal fossa-eminence hemijoint replacement prosthesis: an 8-year retrospective pilot study.

PURPOSE: The purpose of this study was 2-fold: to evaluate the surgical outcome and surgical morbidity of the temporomandibular joint (TMJ) metal fossa-eminence hemijoint prosthesis replacement, implanted in patients with degenerative arthritis, and to establish whether future, more rigorous clinical trial assessment of the hemijoint replacement is warranted. MATERIALS AND METHODS: Eighty-four patients (79 females and 5 males) involving 108 joints (60 unilateral, 24 bilateral) were operated on, and 112 joint metal fossa-eminence prostheses were placed. Information was gathered from patient response questionnaires and clinicoradiographic medical chart review. Change in pain intensity (preoperative versus current) was measured by 2 methods: 1) pain experience (1 to 6) and 2) pain intensity (visual analog scale, 1 to 10). Chewing ability, jaw opening, and joint noise were evaluated (visual analog scales, 1 to 10). Surgical morbidity and implant survival were documented. RESULTS: The average period from initial TMJ symptoms to metal fossa-eminence implant surgery was 12.3 years. The average number of previous TMJ surgeries was 1.9. Pain was reduced 56% and 61.2% by 2 methods. Chewing ability, jaw opening, and joint noise were improved by 53.4%, 50.2%, and 64%, respectively. Nine of 112 implants were explanted during the study period. Patient satisfaction for the clinical outcome was 8.3 on a scale of 0 to 10. CONCLUSION: The surgical placement of the Co-Cr-Mo metal fossa-eminence prosthesis (partial joint replacement) provides significant focal preauricular pain relief and reduces TMJ dysfunction secondary to advanced degenerative arthritis. The results of this case series supports further investigation of this form of surgical management in a rigorously controlled prospective fashion.

Adolescent↗
PubMed1996

[The use of titanium plates and endoprostheses for the mandibular condyles in reconstructive surgery of the mandible].

Potentialities of titanium plates and endoprostheses of the condyle processes in replacement of the postoperative defects of mandibular bone tissue are discussed. A recently developed Russian kit of titanium plates and instruments and specificities of plasty to repair bone defects using this kit are described. The results of surgical repair in 5 patients subjected to resection of the mandible with exarticulation for tumors or osteomyelitis aftereffects were good: the oval of the face and mandibular function were repaired.

Adult↗
PubMed1991

[Studies on biocompatibility of apatite-silicone composite material and investigation of its clinical application].

As reconstructive and prosthetic material of the bone or soft tissue, the author developed a hydroxyapatite composite with silicone (HA-Si composite and studied its biocompatibility to the bone and investigated its clinical application. Si and HA-Si composite containing 30wt%, 50wt%, 70wt% of HA particles were implanted into the rabbit femurs and 2, 4, 12 weeks after, the histological observation was performed. On the surface of the Si fibrous tissue was formed directly, but with the composite, of with the higher HA content, new trabecula were formed from the cortical bone 2 weeks after and the bone developed and contacted the surface directly 4 weeks after and then progressed along the surface. Twelve weeks after the remodeling of the bone progressed and the lamellar structure was recognized. In the bone marrow region new bone formation was observed along the composite and the lamellar structure was recognized. The 70wt% composite showed a good affinity like hydroxyapatite. This composite had elasticity and good handling and biocompatibility to the bone, and it was suggested to be potentially useful for implantation. The 70wt% composite was applied in the clinical cases: mandibular reconstruction (8 cases), additional implantation for deformity of the face (3 cases), alveolar ridge augmentation (3 cases) and supporting of the retention of facial prosthesis (2 cases). The results in the cases of mandibular reconstruction were not satisfactory, however those in the other cases were good so far now. Therefore it was considered that the 70wt% HA-Si composite could be useful in the statical condition.

Adolescent↗
PubMed2002

The causes and consequences of maxillofacial injuries in elderly people.

OBJECTIVE: The occurrence of trauma in older people is well-documented; however the incidence of maxillofacial trauma is scarcely reported. Therefore, the objective of this study is to determine the causes and consequences of maxillofacial trauma in older people. DESIGN: A five-year (March 95 - March 2000) retrospective study was carried out of all patients over the age of 65 years with facial trauma presenting to Accident and Emergency Department (A&E). The information was collected using the medical notes and discharge summaries. SETTING: The Departments of A&E and Maxillofacial Surgery. SUBJECTS: A total of 42 patients' records were examined for study related data. RESULTS: A total of 42 patients were seen during the study period. Thirty-six gave a history of a fall, of which 15 had tripped, 5 had slipped, 3 resulted from a Transient Ischaemic Attack (TIA), 1 as a result of alcohol abuse, in 1 a prosthetic knee gave way and 11 gave no cause for the fall. Of the remaining 6 patients, 5 were assaulted and 1 had a wardrobe fall on top of him. The majority of the falls occurred during the winter months. Maxillofacial injuries were noted in 27 of the 42 patients. Sixteen patients had cheekbone fractures, 8 mandibular fractures, 2 midface and 1 orbital complex fracture. Twenty-five percent of cheekbone fractures and 50% of mandibular fractures were treated surgically. Medical history was noted in 27 patients. CONCLUSIONS: This study clearly demonstrates the majority of the facial trauma in the older people can be treated conservatively unless the patients complain of functional problems.

Accidental Falls↗
PubMedDate not supplied

Immediate loading of Brånemark system implants following placement in edentulous patients: a clinical report.

The purpose of this study was to evaluate the immediate loading of Brånemark System implants following placement with a screw-retained provisional prosthesis in edentulous patients. Twelve mandibular and 5 maxillary arches were treated from December 1997, including 3 bimaxillary patients. The provisional prosthesis, made of heat-polymerizing resin, had an inner casting of cobalt-chromium alloy to provide rigidity. The implants whose placement torque was more than 40 Ncm were immediately loaded. Implants that were placed with placement torque of less than 40 Ncm or that were associated with bone grafting were submerged. Following abutment connection, temporary cylinders were incorporated into the provisional prosthesis intraorally with autopolymerizing resin. After the provisional prosthesis was completed extraorally, it was screw-retained. After a 4- to 6-month healing period, a definitive prosthesis was fabricated and placed. Of the 140 immediately loaded implants, 136 osseointegrated during an 8- to 24-month follow-up period (97.2%). All 17 submerged implants osseointegrated. The results suggest that immediate loading of Brånemark System implants at the time of placement in edentulous patients can be a valuable adjunct to therapy and as predictable as delayed loading, in both mandibular and maxillary arches.

Adult↗
PubMed1982

Treatment of protracted bilateral mandibular dislocation with Proplast-Vitallium prostheses.

A case of bilateral protracted mandibular dislocation complicated by the presence of unusual degenerative changes in the temporomandibular joints is presented. A synopsis of treatment modalities that have been used previously to treat similar conditions is given. Our treatment consisted of bilateral condylectomies, eminectomies, and insertion of Proplast-coated Vitallium condylar prostheses. These procedures resulted in the re-establishment of normal TMJ anatomy, the maintenance of proper posterior mandibular vertical dimension, correction of malocclusion, and relief of the patient's symptoms.

Adult↗
PubMed1984

Mandibular reconstruction using silicone: fifteen-year follow-up.

A patient is presented in whom a carved Dacron felt-covered silicone prosthesis was used to replace the mandible. Although not recommended as the procedure of choice for mandibular reconstruction, the prosthesis remains in place 15 years following implantation, the jaw appears and moves satisfactorily, and speech is within normal limits.

Follow-Up Studies↗
PubMed1998

Implants in mandibular resection.

This clinical report presents a method of satisfactorily restoring a patient with a Class V mandibular defect. Conventional restoration of this patient would have consisted of a soft tissue-supported prosthesis with its inherent instability and associated problems. The use of implants has provided stability and function unobtainable with conventional prosthesis for this patient.

Bone Transplantation↗
PubMed1987

Destructive lesions of the mandibular condyle following diskectomy with temporary silicone implant.

Dacron-reinforced silicone is widely used as disk-replacement implant material in the temporomandibular joint. A retrospective radiographic analysis was undertaken in a series of thirty-two patients on whom diskectomy had been performed. Twenty patients had received temporary silicone implants, whereas twelve patients had surgery without disk-replacement implants. Six of the patients with implants had destructive lesions of the mandibular condyles at follow-up examinations, but no such lesions were seen in any of the patients who had surgery without implants. Histologic analysis of material removed from one patient who had a second operation showed multiple particles of foreign material surrounded by focally marked inflammatory reaction with foreign body granulomas. The underlying cartilage and bone showed focal resorption and bone destruction. Electron microscopy combined with energy-dispersive x-ray microanalysis showed that the foreign material contained silicone. It was concluded that the radiographically observed destructive lesions of the mandibular condyle may be a sign of a reactive synovitis induced by silicone particles abraded from the silicone implant.

Adult↗
PubMed2004

The effect of retainer thickness on posterior resin-banded prostheses: a finite element study.

According to its design concept, a resin-bonded prosthesis, compared with the conventional fixed partial denture, is a weak and unstable structure. Therefore, a resin-bonded prosthesis induces a higher failure rate, especially in the posterior region. Recently, adhesion agents have been profoundly improved. However, the design guidelines of posterior resin-bonded prostheses (RBP) have seldom been evaluated from a biomechanical perspective. The objective of this study was to investigate the biomechanical effects of the retainer thickness on posterior RBP using the finite element method. A solid model of a posterior mandibular resin-bonded prosthesis, which employed the second molar and second premolar as the abutment teeth, was constructed and meshed with various retainer thickness (ranging from 0.2 to 1.0 mm). Horizontal and vertical loadings of 200 N were applied respectively at the central fossa of the pontic to examine the stress level at the interface between the retainer and abutment teeth. All exterior nodes in the root, below the cementoenamel junction were fixed as the boundary condition. The results showed that horizontal loading would induce higher interfacial stresses than the vertical loading which indicated that the horizontal component of the occlusal force plays a more important role in evaluating the debonding phenomenon. Further, the peak interfacial stresses increased as the retainer thickness decreased and, based on the fitted relation between retainer thickness and interfacial stresses, a 0.4 mm retainer thickness was suggested as the minimum required to prevent severe interfacial stresses increasing.

Chemical Phenomena↗
PubMed1994

[Prosthetic rehabilitation following surgical removal of a maxillary or mandibular tumor].

Modern oral cancer therapeutic techniques unfortunately remain too often impairing. On the other hand, rebuilding techniques fortunately allow the patient as well as the practitioner to expect with increasing optimism the restoration of a satisfying function. Those techniques resort, among others, to grafting by bone pedicled transplants and endosseous osseointegratable implants. Irradiated tissues, however, require the utmost care.

Bone Transplantation↗
PubMed1976

Use of acrylic of low polymerization after heminandibulectomy.

Two cases of mandibular reconstruction are presented in which a premolded prosthesis of acrylic of low polymerization covered by silicone rubber was used. We believe that the good results obtained were not only due to the material used, but also because the periosteum and meniscus were preserved in the joint space.

Acrylic Resins↗
PubMed1993

The compressible silicone rubber prosthesis in temporomandibular joint disease.

An alternative technique for temporomandibular joint arthroplasty is described, in which the mandibular condyle is replaced by a soft compressible silicone rubber prosthesis. A modified Nicolle-Calnan metacarpo-phalangeal joint prosthesis was used to reconstruct 31 joints in 24 patients. Results suggest that in those patients where there has been no loss of the prosthesis, function continues to be markedly improved when compared with the pre-operative condition. Painful symptoms were relieved in cases of specific joint pathology but the technique was of little value in the management of dysfunctional pain when radiographic evidence of joint pathology was absent. A specifically designed TMJ prosthesis of this type may be a useful addition to the surgeon's armamentarium.

Adolescent↗
PubMed1992

Erosion and heterotopic bone formation after alloplastic temporomandibular joint reconstruction.

Twenty-three temporomandibular joint arthroplasties using metallic condylar prostheses were performed because of severe ankylosis (8 patients), segmental mandibular resections in tumor surgery (9 patients), and after extensive trauma (2 patients). A clinical and radiological follow-up study showed heterotopic bone formation in 52% of cases and glenoid fossa resorption in 43%. In one patient with rheumatoid arthritis the condyle eroded through the skull base 10 months after surgery. Seven prostheses (30%) were removed and/or exchanged during the average 27.6-month follow-up.

Adult↗
PubMed1982

Measurement of condylar loading forces by instrumented prosthesis in the baboon.

Mathematical models have been developed to predict hypothetical forces acting on the mandibular condyles during mastication, but no direct measurements of condylar forces in vivo have been reported. This preliminary study presents the technical development of an instrumented prosthesis which was implanted in the mandibular ramus of a baboon, and some preliminary data collected while measuring with this prosthesis the condylar forces exerted during simulated mastication under general anaesthesia. Simulated mastication was induced by stimulating the motor tracts of the trigeminal nerve bilaterally, and the forces in response to increasing amperage were recorded. The pathogenesis of TMJ degeneration may be more fully understood by directly measuring the direction and magnitude of forces acting on the condyles during function. In addition, the future development of a total TMJ replacement for traumatized, deranged, or degeneratively impaired joints, must be accomplished with reliably engineered prostheses based upon direct force measurements.

Animals↗
PubMed2005

Total mandibular reconstruction for massive osteolysis of the mandible (Gorham-Stout syndrome).

Massive osteolysis (Gorham-Stout syndrome) is a rare condition of unknown aetiology that is thought to result from a localised endothelial proliferation of lymphatic vessels resulting in destruction and absorption of bone. The diagnosis of Gorham-Stout syndrome can be made only after first excluding osteolysis from infection, inflammation, endocrine disease, and cancer. The syndrome is rarely seen in the facial skeleton and has a variable prognosis. Many treatments have been advocated but only surgery and radiotherapy have had some success. We present a case of massive osteolysis of the entire mandible, which was reconstructed with a free vascularised fibular graft and bilateral prosthetic replacements of the temporomandibular (TMJ) joints. Four years later the fibular graft had been absorbed requiring further reconstruction with another fibula graft.

Bone Transplantation↗