Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.
Identifieur interne : 000A87 ( Ncbi/Checkpoint ); précédent : 000A86; suivant : 000A88Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.
Auteurs : G. Dimitroulis [Australie]Source :
- International journal of oral and maxillofacial surgery [ 1399-0020 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Condyle mandibulaire (), Côtes (transplantation), Enquêtes et questionnaires, Femelle, Humains, Mâle, Procédures de chirurgie orthognathique (), Prothèse articulaire, Qualité de vie, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Troubles de l'articulation temporomandibulaire (), Études rétrospectives.
- MESH :
- Adulte, Adulte d'âge moyen, Condyle mandibulaire, Côtes, Enquêtes et questionnaires, Femelle, Humains, Mâle, Procédures de chirurgie orthognathique, Prothèse articulaire, Qualité de vie, Résultat thérapeutique, Sujet âgé, Sujet âgé de 80 ans ou plus, Troubles de l'articulation temporomandibulaire, Études rétrospectives.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Female, Humans, Joint Prosthesis, Male, Mandibular Condyle (surgery), Middle Aged, Orthognathic Surgical Procedures (methods), Quality of Life, Retrospective Studies, Ribs (transplantation), Surveys and Questionnaires, Temporomandibular Joint Disorders (surgery), Treatment Outcome.
- MESH :
- methods : Orthognathic Surgical Procedures.
- surgery : Mandibular Condyle, Temporomandibular Joint Disorders.
- transplantation : Ribs.
- Adult, Aged, Aged, 80 and over, Female, Humans, Joint Prosthesis, Male, Middle Aged, Quality of Life, Retrospective Studies, Surveys and Questionnaires, Treatment Outcome.
Abstract
The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (P<0.01), rib graft patients were more likely to experience complications (43.8%) necessitating a return to theatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01).
DOI: 10.1016/j.ijom.2014.02.004
PubMed: 24629849
Affiliations:
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Dimitroulis</name><affiliation wicri:level="3"><nlm:affiliation>Maxillofacial Surgery Unit, Department of Surgery, St. Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Australia. Electronic address: geodim25@gmail.com.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Maxillofacial Surgery Unit, Department of Surgery, St. Vincent's Hospital Melbourne, The University of Melbourne, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author></analytic><series><title level="j">International journal of oral and maxillofacial surgery</title><idno type="eISSN">1399-0020</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Joint Prosthesis</term><term>Male</term><term>Mandibular Condyle (surgery)</term><term>Middle Aged</term><term>Orthognathic Surgical Procedures (methods)</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Ribs (transplantation)</term><term>Surveys and Questionnaires</term><term>Temporomandibular Joint Disorders (surgery)</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Condyle mandibulaire ()</term><term>Côtes (transplantation)</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Procédures de chirurgie orthognathique ()</term><term>Prothèse articulaire</term><term>Qualité de vie</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Troubles de l'articulation temporomandibulaire ()</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Orthognathic Surgical Procedures</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Mandibular Condyle</term><term>Temporomandibular Joint Disorders</term></keywords><keywords scheme="MESH" qualifier="transplantation" xml:lang="en"><term>Ribs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Joint Prosthesis</term><term>Male</term><term>Middle Aged</term><term>Quality of Life</term><term>Retrospective Studies</term><term>Surveys and Questionnaires</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Condyle mandibulaire</term><term>Côtes</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Procédures de chirurgie orthognathique</term><term>Prothèse articulaire</term><term>Qualité de vie</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Troubles de l'articulation temporomandibulaire</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (P<0.01), rib graft patients were more likely to experience complications (43.8%) necessitating a return to theatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01).</div></front></TEI><affiliations><list><country><li>Australie</li></country><region><li>Victoria (État)</li></region><settlement><li>Melbourne</li></settlement></list><tree><country name="Australie"><region name="Victoria (État)"><name sortKey="Dimitroulis, G" sort="Dimitroulis, G" uniqKey="Dimitroulis G" first="G" last="Dimitroulis">G. Dimitroulis</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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