Discussion Paper
TMJ DisordersCondylar replacement alone is not sufficient for prosthetic reconstruction of the temporomandibular joint
TMJ Disorders
Section snippets
Case 1
A 64-year-old woman was admitted to the Regional Maxillofacial Unit, Glasgow, UK in April 2004, for a planned right TMJ prosthesis replacement. The patient had suffered from severe TMJ pain for the previous 10 years. Despite an initial conservative approach to the management of her symptoms including adequate denture provision, intra-articular steroids and the use of Dothieprin, the patient required insertion of her first TMJ prosthesis in 1998 (no information on type or origin available).
Case 2
A 61-year-old woman was referred to the Department of Maxillofacial Surgery at Kantonsspital Aarau (Switzerland) in August 1997 for evaluation and treatment of bilateral TMJ pain that she had suffered from for a long period. The pain was getting worse, especially on the right side. Her maximum inter-incisal opening was measured at 48 mm. CT scan demonstrated bilateral deformations and erosions, most severe on the right side, corresponding to arthritis in the TMJ. A conservative treatment was
Discussion
In the past, prosthetic reconstruction of the TMJ resulted in some poor treatment outcomes. To some extent, such failures were the result of sub-optimal design, engineering or function of the devices. Other failures resulted from treating conditions that should not have been treated with prosthetic TMJ reconstruction at all. These previous poor or unpredictable results continue to give prosthetic TMJ reconstruction a bad reputation1. There is still bitterness over the Vitek-Kent TMJ total joint
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