Cargando…

Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication

Background: Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. Methods: A 65-year-ol...

Descripción completa

Detalles Bibliográficos
Autores principales: Ângelo, David Faustino, Maffia, Francesco, Teschke, Marcus, Sanz, David, Galrito, Marta, Cardoso, Henrique, Marques, Rute, Nabuco, Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607587/
https://www.ncbi.nlm.nih.gov/pubmed/37892750
http://dx.doi.org/10.3390/jcm12206612
_version_ 1785127576927207424
author Ângelo, David Faustino
Maffia, Francesco
Teschke, Marcus
Sanz, David
Galrito, Marta
Cardoso, Henrique
Marques, Rute
Nabuco, Carlos
author_facet Ângelo, David Faustino
Maffia, Francesco
Teschke, Marcus
Sanz, David
Galrito, Marta
Cardoso, Henrique
Marques, Rute
Nabuco, Carlos
author_sort Ângelo, David Faustino
collection PubMed
description Background: Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. Methods: A 65-year-old male patient was referred to Instituto Português da Face—Lisbon, Portugal—after failed attempts of mandibular reconstruction secondary to oral carcinoma resection and partial hemi-mandibulectomy plus radiotherapy of 60 total Grays. Primary reconstruction was performed with fibula free flap. Due to failure, secondary reconstructions were performed with osteosynthesis plate without success. The patient was unable to have adequate mastication and deglutition due to a severe crossbite. The authors treated the patient with an extended customized alloplastic temporomandibular joint replacement (F0M2). Results: With 3 years of follow-up, the patient showed an improvement in masticatory function, mandibular motion, pain levels, and overall quality of life. No complications were observed related to ATMJR. Conclusions: The presented case described how ATMJR, although not a validated option after radiotherapy, can be considered to restore functionality in complex cases with bone and soft tissues problems.
format Online
Article
Text
id pubmed-10607587
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-106075872023-10-28 Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication Ângelo, David Faustino Maffia, Francesco Teschke, Marcus Sanz, David Galrito, Marta Cardoso, Henrique Marques, Rute Nabuco, Carlos J Clin Med Article Background: Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. Methods: A 65-year-old male patient was referred to Instituto Português da Face—Lisbon, Portugal—after failed attempts of mandibular reconstruction secondary to oral carcinoma resection and partial hemi-mandibulectomy plus radiotherapy of 60 total Grays. Primary reconstruction was performed with fibula free flap. Due to failure, secondary reconstructions were performed with osteosynthesis plate without success. The patient was unable to have adequate mastication and deglutition due to a severe crossbite. The authors treated the patient with an extended customized alloplastic temporomandibular joint replacement (F0M2). Results: With 3 years of follow-up, the patient showed an improvement in masticatory function, mandibular motion, pain levels, and overall quality of life. No complications were observed related to ATMJR. Conclusions: The presented case described how ATMJR, although not a validated option after radiotherapy, can be considered to restore functionality in complex cases with bone and soft tissues problems. MDPI 2023-10-19 /pmc/articles/PMC10607587/ /pubmed/37892750 http://dx.doi.org/10.3390/jcm12206612 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ângelo, David Faustino
Maffia, Francesco
Teschke, Marcus
Sanz, David
Galrito, Marta
Cardoso, Henrique
Marques, Rute
Nabuco, Carlos
Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title_full Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title_fullStr Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title_full_unstemmed Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title_short Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication
title_sort considerations for the use of alloplastic temporomandibular joint replacement in irradiated patients: report of an off-label indication
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607587/
https://www.ncbi.nlm.nih.gov/pubmed/37892750
http://dx.doi.org/10.3390/jcm12206612
work_keys_str_mv AT angelodavidfaustino considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT maffiafrancesco considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT teschkemarcus considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT sanzdavid considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT galritomarta considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT cardosohenrique considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT marquesrute considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication
AT nabucocarlos considerationsfortheuseofalloplastictemporomandibularjointreplacementinirradiatedpatientsreportofanofflabelindication