Sabine S Linsen1, Annina Oikonomou2, Markus Martini3, Marcus Teschke3. 1. Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany. sabinelinsen@web.de. 2. Department of Prosthodontics, Preclinical Education and Dental Material Science, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany. 3. Department of Oral and Maxillofacial Plastic Surgery, University Hospital Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.
Abstract
OBJECTIVES: The purpose was to analyze mandibular kinematics and maximum voluntary bite force in patients following segmental resection of the mandible without and with reconstruction (autologous bone, alloplastic total temporomandibular joint replacement (TMJ TJR)). MATERIALS AND METHODS: Subjects operated from April 2002 to August 2014 were enrolled in the study. Condylar (CRoM) and incisal (InRoM) range of motion and deflection during opening, condylar retrusion, incisal lateral excursion, mandibular rotation angle during opening, and maximum voluntary bite force were determined on the non-affected site and compared between groups. Influence of co-factors (defect size, soft tissue deficit, neck dissection, radiotherapy, occlusal contact zones (OCZ), and time) was determined. RESULTS: Twelve non-reconstructed and 26 reconstructed patients (13 autologous, 13 TMJ TJR) were included in the study. InRoM opening and bite force were significantly higher (P ≤ .024), and both condylar and incisal deflection during opening significantly lower (P ≤ .027) in reconstructed patients compared with non-reconstructed. Differences between the autologous and the TMJ TJR group were statistically not significant. Co-factors defect size, soft tissue deficit, and neck dissection had the greatest impact on kinematics and number of OCZs on bite force. CONCLUSIONS: Reconstructed patients (both autologous and TMJ TJR) have better overall function than non-reconstructed patients. CLINICAL RELEVANCE: Reconstruction of segmental mandibular resection has positive effects on mandibular function. TMJ TJR seems to be a suitable technique for the reconstruction of mandibular defects including the TMJ complex.
OBJECTIVES: The purpose was to analyze mandibular kinematics and maximum voluntary bite force in patients following segmental resection of the mandible without and with reconstruction (autologous bone, alloplastic total temporomandibular joint replacement (TMJ TJR)). MATERIALS AND METHODS: Subjects operated from April 2002 to August 2014 were enrolled in the study. Condylar (CRoM) and incisal (InRoM) range of motion and deflection during opening, condylar retrusion, incisal lateral excursion, mandibular rotation angle during opening, and maximum voluntary bite force were determined on the non-affected site and compared between groups. Influence of co-factors (defect size, soft tissue deficit, neck dissection, radiotherapy, occlusal contact zones (OCZ), and time) was determined. RESULTS: Twelve non-reconstructed and 26 reconstructed patients (13 autologous, 13 TMJ TJR) were included in the study. InRoM opening and bite force were significantly higher (P ≤ .024), and both condylar and incisal deflection during opening significantly lower (P ≤ .027) in reconstructed patients compared with non-reconstructed. Differences between the autologous and the TMJ TJR group were statistically not significant. Co-factors defect size, soft tissue deficit, and neck dissection had the greatest impact on kinematics and number of OCZs on bite force. CONCLUSIONS: Reconstructed patients (both autologous and TMJ TJR) have better overall function than non-reconstructed patients. CLINICAL RELEVANCE: Reconstruction of segmental mandibular resection has positive effects on mandibular function. TMJ TJR seems to be a suitable technique for the reconstruction of mandibular defects including the TMJ complex.
Authors: Johannes van Gemert; Irene Holtslag; Andries van der Bilt; Matthias Merkx; Ron Koole; Ellen Van Cann Journal: J Craniomaxillofac Surg Date: 2015-04-02 Impact factor: 2.078
Authors: D A Curtis; O Plesh; A J Miller; T A Curtis; A Sharma; R Schweitzer; R L Hilsinger; L Schour; M Singer Journal: Head Neck Date: 1997-07 Impact factor: 3.147