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J Oral Maxillofac Surg. 2015 May;73(5):952-60. doi: 10.1016/j.joms.2014.10.032. Epub 2014 Nov 14.

Twenty-year follow-up study on a patient-fitted temporomandibular joint prosthesis: the Techmedica/TMJ Concepts device.

Author information

1
Clinical Professor, Departments of Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas; Private Practice, Baylor University Medical Center, Dallas, TX. Electronic address: lwolford@drlarrywolford.com.
2
Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; Clinical Consultant, TMJ Concepts, Ventura, CA.
3
Professor, Department of Biomedical Sciences, Texas A&M University Health Science Center, Baylor College of Dentistry, Dallas, TX.
4
Former Fellow, Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX; Clinical Assistant Professor, Department of Orthodontics, St Louis University, Center for Advanced Dental Education, St Louis, MO.
5
Former Fellow, Department of Oral and Maxillofacial Surgery, Texas A&M University Health Science Center, Baylor College of Dentistry, Baylor University Medical Center, Dallas, TX; Private Practice, Louisville, KY.

Abstract

PURPOSE:

To evaluate subjective and objective outcomes of patients receiving Techmedica (currently TMJ Concepts) patient-fitted temporomandibular joint (TMJ) total joint replacement (TJR) devices after 19 to 24 years of service.

PATIENTS AND METHODS:

This prospective cohort study evaluated 111 patients operated on by 2 surgeons using Techmedica (Camarillo, CA) patient-fitted TMJ TJR devices from November 1989 to July 1993. Patients were evaluated before surgery and at least 19 years after surgery. Subjective evaluations used standard forms and questions with a Likert scale for 1) TMJ pain (0, no pain; 10, worst pain imaginable), 2) jaw function (0, normal function; 10, no movement), 3) diet (0, no restriction; 10, liquid only), and 4) quality of life (QoL; improved, the same, or worse). Objective assessment measured maximum incisal opening (MIO). Comparison analysis of presurgical and longest follow-up data used nonparametric Mann-Whitney and Wilcoxon signed rank tests. Spearman correlations evaluated the number of prior surgeries in relation to objective and subjective variables.

RESULTS:

Of the 111 patients, 56 (50.5%) could be contacted and had adequate records for inclusion in the study. Median follow-up was 21 years (interquartile range [IQR], 20 to 22 yr). Mean age at surgery was 38.6 years (standard deviation, 10 yr). Median number of previous TMJ surgeries was 3 (IQR, 4). Presurgical and longest follow-up data comparison showed statistically significant improvement (P < .001) for MIO, TMJ pain, jaw function, and diet. At longest follow-up, 48 patients reported improved QoL, 6 patients reported the same QoL, and 2 patients reported worse QoL. Spearman correlations showed that an increased number of previous surgeries resulted in lower levels of improvement for TMJ pain and MIO.

CONCLUSIONS:

At a median of 21 years after surgery, the Techmedica/TMJ Concepts TJR continued to function well. More previous TMJ surgeries indicated a lesser degree of improvement. No devices were removed owing to material wear.

PMID:
25631865
DOI:
10.1016/j.joms.2014.10.032
[Indexed for MEDLINE]

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