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Abstract: Clinical evaluation of patients with temporomandibular joint implants

  [ 69 votes ]   [ Discuss This Article ]
www.ProHealth.com • December 5, 2002


J Oral Maxillofac Surg 2002 Dec;60(12):1389-1399

Ta LE, Phero JC, Pillemer SR, Hale-Donze H, McCartney-Francis N, Kingman A, Max MB, Gordon SM, Wahl SM, Dionne RA.

Postdoctoral Fellow, Pain and Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda, MD., dagger Professor, Department of Anesthesia, University of Cincinnati Medical Center, Cincinnati, OH., double dagger Staff Clinician, Gene Therapy and Therapeutic Branch, National Institutes of Health, Bethesda, MD., section sign Postdoctoral Fellow, Oral Infection and Immunity Branch, National Institutes of Health, Bethesda, MD., parallel Staff Scientist, Oral Infection and Immunity Branch, National Institutes of Health, Bethesda, MD., paragraph sign Staff Scientist, Biostatistics Core, National Institute of Dental and Craniofacial Research, Bethesda, MD., #Senior Investigator, Pain and Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda, MD., Staff Scientist, Oral Infection and Immunity Branch, National Institutes of Health, Bethesda, MD., dagger dagger Chief, Oral Infection and Immunity Branch, National Institutes of Health, Bethesda, MD., double dagger double dagger Chief, Pain and Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda, MD.

PURPOSE: An undetermined number of patients with temporomandibular joint (TMJ) symptoms have been treated with intra-articular disc implants composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have shown the potential to fragment in situ resulting in nonbiodegradable particles that stimulate a giant cell reaction and lead to degeneration of local structures, pain, and limitation of mandibular opening. We examined the possible relationship between TMJ implants and persistent pain, responses to sensory stimuli, quality of life, and systemic immune dysfunction.

PATIENTS AND METHODS: This case series (32 patients) were referred from university-based orofacial pain centers and private practices from across the United States. Laboratory and clinical assessments evaluated orofacial pain symptoms, neurologic function, clinical signs and symptoms of rheumatologic disease, physical function, systemic measures of immune function, and behavioral measures.

RESULTS: We found that TMJ implant patients appeared to have altered sensitivity to sensory stimuli, a higher number of tender points with a diagnosis of fibromyalgia, increased self-report of chemical sensitivity, higher psychologic distress and significantly lower functional ability. Systemic illness or autoimmune disease was not evident in this series of TMJ implant patients.

CONCLUSIONS: Significant problems were noted on clinical assessment of TMJ implant patients. This is a US government work. There are no restrictions on its use. J Oral Maxillofac Surg 60:1389-1399, 2002

PMID: 12464999 [PubMed - as supplied by publisher]




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