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Accepted Manuscript

A comparison of clinical follow-up of different total temporomandibular joint

replacement prostheses：a systematic review and meta–analysis

Luxiang Zou, DDS, Dongmei He, DDS, MD, Edward Ellis, DDS, MS

PII: S0278-2391(17)31145-X

DOI: 10.1016/j.joms.2017.08.022

Reference: YJOMS 57957

To appear in:

Journal of Oral and Maxillofacial Surgery

Received Date: 25 June 2017

Revised Date: 12 August 2017

Accepted Date: 12 August 2017

Please cite this article as: Zou L, He D, Ellis E, A comparison of clinical follow-up of different total

temporomandibular joint replacement prostheses：a systematic review and meta–analysis, Journal of

Oral and Maxillofacial Surgery (2017), doi: 10.1016/j.joms.2017.08.022.

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to

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MANUS CRIP T

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Abstract

Background: There are different total TMJ prostheses on the market today but no

comparison of the efficacy. The purpose of this meta-analysis was to evaluate the

effectiveness of different temporomandibular joint replacement (TJR) systems.

Methods: A systematic review and meta-analysis was performed using the Pubmed,

Embase, Medline and Cochrane Library search engines in May 2017 to identify

qualified studies. The outcome measures were the changes between the pre- and

postoperative maximal incisal opening (MIO), the level of pain relief, diet limitations

and function deficiencies. Analyses of heterogeneity, sensitivity and publication bias

were performed. A fixed-effects model was used in the meta-analysis of pooled

weighted mean difference (WMD) in the MIO pre- and post-operation, pain changes,

diet changes and functional improvement.

Result: Twenty studies with 1262 patients were included into the meta-analysis. There

was no real difference in the comparison of MIO and pain, diet, function changes pre-

and post-operation of three different brands of TJR systems. The MIO and function

efficiency decreased gradually with time, but the effectiveness of pain relief and

improvements in diet limitation were stable with no significant differences over the

follow-up period. In the comparison of the custom and stock devices, both types of

prostheses performed similarly in MIO, pain, function and diet changes between pre-

and post-operation.

Conclusion: The analysis showed that there was no significant difference in treatment

outcomes among the different brands of TJR systems.

Introduction

The temporomandibular joint is the only diarthrodial joint in our body,

performing both translation and rotation movements. Temporomandibular joint

replacement (TJR) is regarded as the final method of reconstruction the TMJ for

patients with end-stage joint disease. The initial use of alloplastic materials for TMJ

reconstruction failed in the 1970s due to problems with the Kent/Vitek prostheses,

since it caused many foreign body reactions to the Proplast® and Teflon® used in the

manufacture of the glenoid fossa component of the prosthesis.

1,2

Over the past thirty

years, the development of the Nexus (previously Christensen, TMJ Implants Inc.; Salt

Lake City, UT, USA), TMJ Concepts (Ventura, CA USA) and Biomet (Jacksonville,

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