Kinematic Assessment of the Temporomandibular Joint Before and After Partial Metal Fossa Eminence Replacement Surgery: A Prospective Study

Baltalı, Evre; Zhao, Kristin D.; Koff, Matthew F.; Durmuş, Ercan; An, Kai-Nan; Keller, Eugene E.

doi:10.1016/j.joms.2007.09.014

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 7 , Pages 1383-1389, July 2008

Kinematic Assessment of the Temporomandibular Joint Before and After Partial Metal Fossa Eminence Replacement Surgery: A Prospective Study

Evre Baltalı, DDS, PhD
- Research Fellow and Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, and Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Selçuk University, Konya, Turkey.
- Address correspondence and reprint requests to Dr Baltali: Oral and Maxillofacial Surgery, 200 First Street SW, Mayo Clinic, Rochester, MN, 55905
Kristin D. Zhao, MA
- Assistant Professor, Biomechanics/Motion Analysis Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
Matthew F. Koff, PhD
- Senior Research Fellow, Biomechanics/Motion Analysis Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
Ercan Durmuş, DDS, PhD
- Associate Professor, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Selçuk University, Konya, Turkey.
Kai-Nan An, PhD
- Chair and Professor, Biomechanics/Motion Analysis Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN.
Eugene E. Keller, DDS, MSD
- Chair and Professor, Division of Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.

Purpose

This study compared the functional kinematic outcome of the temporomandibular joint (TMJ) in patients with end-stage TMJ osteoarthritis before and after TMJ hemijoint replacement surgery.

Materials and Methods

Fourteen patients (15 joints), with a mean age of 46.1 years, undergoing metal fossa eminence hemijoint replacement surgery, participated in this study. Each patient's jaw motion was recorded using an electromagnetic tracking device and patient-specific computed tomography images. A visual analog scale patient response questionnaire was used before and after the operation to assess the subjective outcome of the surgery.

Results

The mean linear distance (LD) traveled by the incisors increased significantly due to the surgical intervention, from 30.4 ± 6.9 mm preoperatively to 35.5 ± 5.3 mm postoperatively (P = .02). The LD of the operated condyle decreased from 14.1 ± 5.7 mm to 11.4 ± 6.2 mm, but this was not significant. The mean LD for the unoperated condyle remained similar (preoperative, 13.2 ± 5.9 mm; postoperative, 13.3 ± 6.5 mm). The total mandibular rotation increased significantly, from 19.3 ± 4.9 degrees preoperatively to 24.8 ± 3.9 postoperatively (P < .01).

Conclusions

Kinematic data support the functional efficiency of hemijoint replacement surgery, with benefits of increased maximal mouth opening, preservation of operated and unoperated condyle translation motion, and increased mandibular rotation.