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Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report
BACKGROUND: There are several indications for partial or total replacement of the temporomandibular joint (TMJ), including neoplasms and severe bone resorptions. In this regard, several techniques have been suggested to increase the functionality and longevity of these prosthetic devices. This case...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9335964/ https://www.ncbi.nlm.nih.gov/pubmed/35906643 http://dx.doi.org/10.1186/s13005-022-00331-4 |
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author | Puricelli, Edela |
author_facet | Puricelli, Edela |
author_sort | Puricelli, Edela |
collection | PubMed |
description | BACKGROUND: There are several indications for partial or total replacement of the temporomandibular joint (TMJ), including neoplasms and severe bone resorptions. In this regard, several techniques have been suggested to increase the functionality and longevity of these prosthetic devices. This case report describes the treatment of a TMJ ankylosis patient with the Puricelli biconvex arthroplasty (ABiP) technique, with a long-term follow-up. CASE PRESENTATION: In 1978, a 33-year-old male polytraumatised patient developed painful symptoms in the right preauricular region, associated with restricted movement of the ipsilateral TMJ. Due to subcondylar fracture, an elastic maxillomandibular immobilisation (EMMI) was applied. Subsequently, the patient was referred for treatment when limitations of the interincisal opening (10 mm) and the presence of spontaneous pain that increased on palpation were confirmed. Imaging exams confirmed the fracture, with anteromedial displacement and bony ankylosis of the joint. Exeresis of the compromised tissues and their replacement through ABiP was indicated. The method uses conservative access (i.e., preauricular incision), partial resection of the ankylosed mass, and tissue replacement using two poly(methyl methacrylate) components, with minimal and stable contact between the convex surfaces. At the end of the procedure, joint stability and dental occlusion were tested. The patient showed significant improvement at the postoperative 6-month follow-up, with no pain and increased mouth opening range (30 mm). At the 43-year follow-up, no joint noises, pain or movement restrictions were reported (mouth opening of 36 mm). Imaging exams did not indicate tissue degeneration and showed the integrity of prosthetic components. CONCLUSIONS: The present case report indicates that ABiP enables joint movements of the TMJ, allowing the remission of signs and symptoms over more than 40 years of follow-up. These data suggest that this technique is a simple and effective alternative when there is an indication for TMJ reconstruction in adult patients with ankylosis. |
format | Online Article Text |
id | pubmed-9335964 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-93359642022-07-30 Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report Puricelli, Edela Head Face Med Research BACKGROUND: There are several indications for partial or total replacement of the temporomandibular joint (TMJ), including neoplasms and severe bone resorptions. In this regard, several techniques have been suggested to increase the functionality and longevity of these prosthetic devices. This case report describes the treatment of a TMJ ankylosis patient with the Puricelli biconvex arthroplasty (ABiP) technique, with a long-term follow-up. CASE PRESENTATION: In 1978, a 33-year-old male polytraumatised patient developed painful symptoms in the right preauricular region, associated with restricted movement of the ipsilateral TMJ. Due to subcondylar fracture, an elastic maxillomandibular immobilisation (EMMI) was applied. Subsequently, the patient was referred for treatment when limitations of the interincisal opening (10 mm) and the presence of spontaneous pain that increased on palpation were confirmed. Imaging exams confirmed the fracture, with anteromedial displacement and bony ankylosis of the joint. Exeresis of the compromised tissues and their replacement through ABiP was indicated. The method uses conservative access (i.e., preauricular incision), partial resection of the ankylosed mass, and tissue replacement using two poly(methyl methacrylate) components, with minimal and stable contact between the convex surfaces. At the end of the procedure, joint stability and dental occlusion were tested. The patient showed significant improvement at the postoperative 6-month follow-up, with no pain and increased mouth opening range (30 mm). At the 43-year follow-up, no joint noises, pain or movement restrictions were reported (mouth opening of 36 mm). Imaging exams did not indicate tissue degeneration and showed the integrity of prosthetic components. CONCLUSIONS: The present case report indicates that ABiP enables joint movements of the TMJ, allowing the remission of signs and symptoms over more than 40 years of follow-up. These data suggest that this technique is a simple and effective alternative when there is an indication for TMJ reconstruction in adult patients with ankylosis. BioMed Central 2022-07-29 /pmc/articles/PMC9335964/ /pubmed/35906643 http://dx.doi.org/10.1186/s13005-022-00331-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Puricelli, Edela Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title | Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title_full | Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title_fullStr | Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title_full_unstemmed | Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title_short | Puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
title_sort | puricelli biconvex arthroplasty as an alternative for temporomandibular joint reconstruction: description of the technique and long-term case report |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9335964/ https://www.ncbi.nlm.nih.gov/pubmed/35906643 http://dx.doi.org/10.1186/s13005-022-00331-4 |
work_keys_str_mv | AT puricelliedela puricellibiconvexarthroplastyasanalternativefortemporomandibularjointreconstructiondescriptionofthetechniqueandlongtermcasereport |