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Deterioration of temporary silicone implant in the temporomandibular joint: a clinical and arthroscopic follow-up study.


Dacron-reinforced silicone material was used as a temporary disk replacement implant in twenty-seven consecutive patients who underwent diskectomy. Symptoms and the status of the implants were recorded when the implants were removed 1 to 19 months postoperatively (median, 4 months). At the time of removal of the implants, eleven patients showed mechanical dysfunction, which was associated with pain in four patients. All but one of the implants showed wearing facets, and fifteen implants were cracked or perforated. Arthroscopic examination was performed when the implant was removed in the last six patients. This revealed that the extension of the joint compartment corresponded well to the dimension of the implant. Arthroscopy also disclosed that initially even and shiny articular surfaces remained so, articular surfaces in joints with fibrous ankylosis became shiny but uneven, and arthrotic articular surfaces showed no changes. It was concluded that disk-replacement implants can prevent postoperative ingrowth of fibrous tissue and development of intra-articular adhesions and that the implant has the capacity to protect the articular surfaces as long as the material is intact. Since more than half of the implants were cracked or perforated, an implant material with mechanical properties superior to those of Dacron-reinforced silicone would be preferable.

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