Clinical and Radiologic Follow-Up of Zimmer Biomet Stock Total Temporomandibular Joint Replacement After Surgical Modifications.

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons(2018)

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摘要
PURPOSE:The aim of this study was to evaluate the clinical and radiologic results of Zimmer Biomet stock prostheses (Jacksonville, FL) in temporomandibular joint replacement after surgical modifications during at least 1 year of follow-up. PATIENTS AND METHODS:We recruited patients treated by Zimmer Biomet stock prostheses after technical modifications, including digital templates, autogenous ipsilateral bone grafting from the mandible to the fossa, salvaging of the disc remnant and suturing it to the medial aspect of the prosthesis, and fat grafts from a retromandibular incision, between 2010 and 2016. Clinical examination findings including maximal incisal opening; visual analog scale scores for pain, diet, and mandibular movement; and quality of life were compared before the operation and at least 1 year postoperatively. The status of the fossa bone graft was evaluated by computed tomography examination. RESULTS:The study comprised 38 joints in 33 patients with diagnoses including osteoarthritis, ankylosis, and neoplasm. Compared with before the operation, maximal incisal opening and visual analog scale scores for diet, function, and pain level, as well as the quality-of-life survey score, were considerably improved during the last follow-up. Computed tomography scans showed all bone grafts were completely healed within the fossa 1 year after surgery. There was no ectopic bone formation, screw loosening, or component displacement or breakage. CONCLUSIONS:Our surgical modifications of Zimmer Biomet stock prostheses showed good results for at least 1 year of follow-up.
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