Total prosthetic replacement of the TMJ: experience with two systems 1988-1997

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Orthopedic Surgery

Background:

• Temporomandibular joint (TMJ) disorders affect a significant patient population, often necessitating prosthetic replacement.
• Previous surgical interventions were common in patients undergoing TMJ replacement.
• Degenerative arthropathy, osteoarthritis, and rheumatoid arthritis were primary indications for TMJ replacement.

Purpose of the Study:

• To evaluate the clinical outcomes and success rates of the Vitek VK II and Christensen systems for total temporomandibular joint prosthetic replacement.
• To compare the efficacy of the two prosthetic systems in terms of pain reduction and functional improvement.

Main Methods:

• Retrospective case series of 62 patients (86 joints replaced) between 1988 and 1997.
• Utilized Vitek VK II and Christensen prostheses, with follow-up periods ranging from 1 to 120 months (median 14.5 months).
• Assessed patient-reported outcomes including ability to eat and pain levels, alongside prosthesis survival and complication rates.

Main Results:

• Significant improvement in ability to eat all food types (23% preoperatively to 77% postoperatively) and reduction in severe pain (63% preoperatively to 5% postoperatively).
• Overall success rate of 94% for both patients and joints replaced.
• The Vitek VK II system demonstrated an 82% success rate for patients and 89% for joints, with four cases requiring revision to Christensen prostheses due to foreign body giant cell reaction.

Conclusions:

• Both Vitek VK II and Christensen systems offer high success rates for total temporomandibular joint replacement.
• These prostheses significantly enhance patient function and quality of life by alleviating pain and improving masticatory ability.
• While generally successful, the Vitek VK II system showed a higher rate of revision surgery, indicating potential material or design considerations.