4.3 Article

Utilization of extended temporomandibular joint replacements in patients with hemifacial microsomia

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CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2023.05.009

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Hemifacial microsomia; Malocclusion; Total joint replacement; Temporomandibular joint; Jaw abnormalities

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Hemifacial microsomia (HFM) patients may benefit from extended temporomandibular joint replacements (eTMJR) to improve function and quality of life. A cross-sectional survey was conducted to assess surgeons' experiences with and complications of eTMJR in HFM patients. The results showed that most surgeons reported good functional outcomes and few complications after eTMJR in HFM patients. Therefore, eTMJR could be considered a viable option in the management of this patient population.
Hemifacial microsomia (HFM) patients may benefit from extended temporomandibular joint replacements (eTMJR) to improve function and quality of life. A cross-sectional survey was sent to surgeons who place alloplastic temporomandibular joints regarding their experience with and complications encountered when placing eTMJR in patients with HFM. Fifty-nine responded to the survey. Thirty-six (61.0%) reported treating patients with HFM and 30 (50.8%) of those reported placing an alloplastic temporomandibular joint (TMJ) prosthesis for patients with HFM. Twenty-three of the 30 surgeons (76.7%) placing alloplastic TMJ prostheses reported using an eTMJR in patients with HFM. The average maximum inter-incisal opening (MIO) after an eTMJR in HFM patients was reported as > 25 mm by 82.6% of the participants, and between 16 mm and 25 mm by 17.4%. No participants reported MIO < 15 mm. To avoid condylar sag and open bite changes postoperatively, over 70% reported using some form of modification to stabilize the occlusion. Respondents reported good functional outcomes for eTMJR in patients with HFM with relatively few complications. Therefore, eTMJR could be considered a viable option in the management of this patient population.

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