CUSTOM CAD-CAM TOTAL TEMPOROMANDIBULAR-JOINT RECONSTRUCTION SYSTEM - PRELIMINARY MULTICENTER REPORT

Purpose: The purpose was to test the outcome of a custom computer assi sted design/computer assisted manufactured (CAD/CAM) total temporomand ibular joint (TMJ) reconstruction system. Patients and Methods: There were 215 patients (13 males and 202 females); the average age at recon struction was 40.9 +/- 10.3 years (range, to 77 years). There were 363 joints placed, 296 bilateral and 67 unilateral. The patients had TMJ problems for an average of 10.3 +/- 7.0 years (range, 1 to 44 years), and had undergone a mean of 5.4 +/- 4.8 (range, 0 to 28) prior unsucce ssful surgeries. Preoperative and postoperative data were collected fo r up to 48 months using a standardized data collection format. Subject ive data related to pain, function of the lower jaw, and diet, were ob tained using a visual analogue scale. Objective measures of mandibular range of motion were made directly on the patient preoperatively and postoperatively. Results: Preliminary analysis of these data reveals a statistically significant decrease in pain, an increase in function, and improvement in diet (P < .0001) from the preoperative measurements to 1 and 2 years postoperatively. There was also improvement in mandi bular vertical range of motion. The number of previous surgeries was a strong predictor of postoperative pain, function, and diet scores, as well as of maximal interincisal opening. A life table analysis of fai lures indicates good durability of the prosthesis over time. Conclusio n: These preliminary data indicate that this custom CAD/CAM total TMJ reconstruction system seems to be useful in the treatment of the multi ply operated, and/or anatomically multilated TMJ.