IADR Abstract Archives

Incidence of Contralateral Joint Surgeries After TMJ Total Joint Reconstruction

Objective: Temporomandibular joint total reconstruction (TJR) is indicated in end-stage TMJ disease (TMD). The mandibular function becomes asymmetric after TJR due to the lack of condylar translation. This unbalanced load distribution can result in adverse effects on the contralateral joint. This study aims to examine the likelihood of requiring subsequent surgeries on the contralateral joint after a successful unilateral TJR with metal on ultra-high-molecular-weight polyethylene prosthesis.

Methods:  Data were collected from patient records and surgical logs from the past thirteen years in the TMJ practice at Department of Veteran’s Affairs Medical Center in San Francisco. A total of 77 subjects, who met all inclusion/exclusion criteria, were diagnosed with TMD according to research diagnostic criteria for TMD (RDC/TMD) and received successful unilateral TMJ surgeries. Subjects who received TJR (n=25) and non-TJR surgeries (n=52) were evaluated separately. The two-proportion z-test was used to determine whether subjects with TJR are more likely to receive subsequent contralateral joint surgeries than subjects with non-TJR. Chi-square and t-tests were used to compute the correlated factors among subjects with or without subsequent contralateral joint surgeries post-TJR.

Results:  Subjects who had TJR were significantly more likely to have received subsequent contralateral joint surgeries (32%) than subjects who had non-TJR surgeries (15%) (p<0.05). Of the subjects who developed symptoms on the contralateral joints after unilateral TJR, 88% received TJR (95% CI 0.5078-0.9989). Gender, age and bruxism did not show significant correlation to receiving subsequent contralateral surgeries after unilateral TMJ surgery.

Conclusion:  A TJR is correlated with TMD symptoms on the contralateral joint, which may require subsequent surgeries. Monitoring contralateral joint post-TJR may be necessary to track the progression of the disease.

IADR/AMER General Session
2014 IADR/AMER General Session (Cape Town, South Africa)
Cape Town, South Africa
2014
112
Oral & Maxillofacial Surgery
  • Myung, Jane  ( University of California San Francisco School of Dentistry, San Francisco, CA, USA )
  • Connelly, Stephen  ( Department of Veteran Affairs Medical Center, San Francisco, San Francisco, CA, USA ;  University of California San Francisco School of Dentistry, San Francisco, CA, USA )
  • Silva, Rebeka  ( Department of Veteran Affairs Medical Center, San Francisco, San Francisco, CA, USA ;  University of California San Francisco School of Dentistry, San Francisco, CA, USA )
    • Oral Session
    Oral & Maxillofacial Surgery I
    06/25/2014