Custom CAD/CAM total temporomandibular joint reconstruction system: preliminary multicenter report

J Oral Maxillofac Surg. 1995 Feb;53(2):106-15; discussion 115-6. doi: 10.1016/0278-2391(95)90381-x.

Abstract

Purpose: The purpose was to test the outcome of a custom computer assisted design/computer assisted manufactured (CAD/CAM) total temporomandibular joint (TMJ) reconstruction system.

Patients and methods: There were 215 patients (13 males and 202 females); the average age at reconstruction was 40.9 +/- 10.3 years (range, 15 to 77 years). There were 363 joints placed, 296 bilateral and 67 unilateral. The patients had TMJ problems for an average of 10.3 +/- 7.0 years (range, 1 to 44 years), and had undergone a mean of 5.4 +/- 4.8 (range, 0 to 28) prior unsuccessful surgeries. Preoperative and postoperative data were collected for up to 48 months using a standardized data collection format. Subjective data related to pain, function of the lower jaw, and diet, were obtained using a visual analogue scale. Objective measures of mandibular range of motion were made directly on the patient preoperatively and postoperatively.

Results: Preliminary analysis of these data reveals a statistically significant decrease in pain, an increase in function, and improvement in diet (P < .0001) from the preoperative measurements to 1 and 2 years postoperatively. There was also improvement in mandibular vertical range of motion. The number of previous surgeries was a strong predictor of postoperative pain, function, and diet scores, as well as of maximal interincisal opening. A life table analysis of failures indicates good durability of the prosthesis over time.

Conclusion: These preliminary data indicate that this custom CAD/CAM total TMJ reconstruction system seems to be useful in the treatment of the multiply operated, and/or anatomically mutilated TMJ.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Computer-Aided Design*
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis*
  • Life Tables
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure
  • Range of Motion, Articular
  • Regression Analysis
  • Reoperation
  • Survival Analysis
  • Temporomandibular Joint / injuries
  • Temporomandibular Joint Disorders / surgery*
  • Treatment Outcome