Method: Retrospectively, 25 patients who had been diagnosed with AICR and had had total joint prostheses placed were evaluated for skeletal stability, mandibular function and pain. Measurements from immediate postoperative and longest available follow-up were compared. Cephalometric radiographs were used to measure changes in the jaws vertically and horizontally. Changes in the occlusal plane, SNA, SNB, the mandibular plane angle (MPA), total mandibular length (Go-Gn), palatal plane angle and gonial angle determined skeletal stability. Visual analog scales evaluated changes in levels of pain and jaw function. Maximum interincisal opening and lateral excursive movements were compared between time points.
Result: The average postoperative follow-up time was 14.85 months. At the longest follow-up the occlusal plane, palatal plane, SNA, SNB and Go-Gn showed very little change relative to the immediate postoperative timepoint. On average, the MPA decreased by 2.1° ±0.5 and the gonial angle decreased by 2.03° ± 0.77. Although both values were statistically significant (p<0.05), neither was clinically significant. Postoperatively, the maximum interincisal opening increased by an average of 3.8mm ±0.9 but lateral excursive movements decreased significantly, as was expected due to the nature of the prosthesis. All patients reported an improvement in function. However, 2 patients reported no improvement in pain, and 1 reported having worse pain than preoperatively.
Conclusion: Total joint replacement used in the treatment of patients with AICR has been shown to be skeletally stable and improves function and pain levels in the large majority of patients.