Alloplastic or autogenous reconstruction of the TMJ

Journal of Oral Biology and Craniofacial Research
A Sidebottom

Abstract

Reconstruction of the irreparably damaged temporomandibular joint (TMJ) is dependent on the cause of damage and the patient's age. In childhood the current preference is for autogenous reconstruction which can potentially "grow" with the child. This is either with soft tissue interposition (temporalis fascial interposition), local osteotomy, distraction osteogenesis, non-vascularised tissue (costochondral, sternoclavicular) or vascularised tissue (second metatarsal). Current debate centres around the possibility of alloplastic reconstruction particularly where autogenous tissue has failed. The resultant failure of growth - if this occurs, can be dealt with in late adolescence with either osteotomy, distraction osteogenesis or replacement of the condylar component of the prosthesis. In the adult the choice is currently in favour of alloplastic reconstruction as this gives a more stable long term result and facilitates early mobilisation. Initial cost is clearly an issue, but when weighted against the reduced length of stay and reduced morbidity, often the costs are equivalent in the short term and come to benefit alloplasts in the medium term. Their long term outcomes beyond 15 years are however not clear.

Citations

Sep 8, 2017·Journal of Orthodontics·Renato Parsekian MartinsJoão Roberto Gonçalves
Dec 30, 2016·The Journal of Craniofacial Surgery·Kunjie LiuJuanhong Meng
Feb 3, 2018·International Journal of Molecular Sciences·Xavier Van BellinghenFlorence Fioretti
Oct 6, 2016·Current Osteoporosis Reports·Ashkan AryaeiKyriacos A Athanasiou
Feb 9, 2021·Plastic and Reconstructive Surgery. Global Open·Rafael P TiongcoHugo St Hilaire
Oct 15, 2020·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Sabine S LinsenMarcus Teschke
Apr 1, 2021·Journal of Oral Biology and Craniofacial Research·Divya MehrotraPeter Evans
Jun 14, 2021·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Mathilde SarlabousDavid J Psutka
Jul 21, 2021·Seminars in Roentgenology·Marie TominnaArthur B Meyers
Jul 24, 2021·Journal of Oral Biology and Craniofacial Research·Ajoy RoychoudhuryAnson Jose
Jul 20, 2021·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Sabine S LinsenLouis G Mercuri
Jun 4, 2021·The Journal of Craniofacial Surgery·Zlatan HodzicJuho Suojanen

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