Temporomandibular joint replacement: a New Zealand perspective

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Orthopedic Surgery

Background:

• Alloplastic total temporomandibular joint replacement (TMJ TJR) using patient-fitted systems has been utilized in New Zealand since 2000.
• TMJ TJR is indicated for end-stage temporomandibular joint (TMJ) disease, including ankylosis and arthritis.
• The TMJ Concepts system is a patient-fitted prosthesis used for TMJ TJR.

Purpose of the Study:

• To evaluate the outcomes and complications of TMJ TJR using the TMJ Concepts system in New Zealand.
• To assess the effectiveness of TMJ TJR in managing end-stage TMJ disease.
• To determine the reliability of TMJ TJR as a treatment option.

Main Methods:

• Retrospective analysis of data collected via questionnaires sent to maxillofacial surgeons in New Zealand.
• Inclusion of data from all TMJ Concepts devices implanted between 2000 and 2011.
• Analysis of 63 devices implanted in 42 patients (13 males, 29 females).

Main Results:

• The primary indication for TMJ TJR was end-stage joint disease (ankylosis, arthritis).
• Mean patient age was 47 years (range 7-80 years).
• Maximal incisional opening improved by a mean of 17.3mm (P<0.01).
• 90% of patients reported an improved quality of life.
• Transient facial nerve impairment occurred in 4.8% of patients, the most common complication.

Conclusions:

• TMJ TJR using the TMJ Concepts prosthesis is a reliable treatment for end-stage TMJ disease.
• The procedure leads to significant functional improvements and enhanced quality of life.
• Low complication rates support the efficacy of this treatment option.