Subjective and objective outcomes in patients reconstructed with a custom-fitted alloplastic temporomandibular joint...

This study looked at prospective subjective and objective preoperative and postoperative outcome data from a set of multiply operated, anatomically mutilated, functionless, chronic temporomandibular joint (TMJ) pain patients who have undergone TMJ reconstruction with a custom-fitted prosthetic system.

Two hundred fifteen patients (363 joints: 296 bilateral, 67 unilateral) who had undergone total TMJ reconstruction with a custom-fitted TMJ prosthesis (Techmedica; now TMJ Concepts, Camarillo, CA) made up the subjects reviewed in this study. The mean follow-up period was 30.7 months. The patients were divided into 3 groups based on the number of prior unsuccessful TMJ arthrotomies they had undergone (group 1 = 0 to 2; group 2 = 3 to 8; and group 3 = 9 or more)

Subjective improvement ratio data indicated that postoperatively group 1 had a 61.3% improvement in subjective parameters, group 2 had a 51.0% improvement, and group 3 had only a 27.5% improvement. Objective improvement ratio data showed that postoperatively group 3 had the largest increase in maximum interincisal opening, whereas the other groups had less improvement.

The data from this study confirm, as previously reported in the literature, that the greater the number of surgical procedures performed on the TMJ, the less the chance of significant subjective improvement.