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Clinical assessment of acellular dermal matrix (AlloDerm©) as an option in the replacement of the temporomandibular joint disc: A pilot study - 18/01/20

Doi : 10.1016/j.jormas.2019.12.018 
M.H. Patel a, , R.Y. Kim b, S. Aronovich c, C.A. Skouteris c
a University of Maryland Medical Center, Department of Oral and Maxillofacial Surgery, 22 S Greene Street, 21201 Baltimore, USA 
b Head and Neck Oncologic and Microvascular Reconstructive Surgery, John Peter Smith Hospital, Baylor Scott & White, Fort Worth, TX, USA 
c University of Michigan Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, USA 

Corresponding author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le samedi 18 janvier 2020

Abstract

Background

There is limited data available in the literature describing the utility of acellular dermal matrix (AlloDerm©) in the replacement of the temporomandibular joint disc. Few reports of clinicians using implantable AlloDerm to replace the disc do exist, however, this has been described for reconstruction after surgical resection of the entire temporomandibular joint complex to treat pathology, as opposed to isolated articular disc disorders. Moreover, there is a lack of description in the literature regarding associated perioperative outcomes after such a procedure. We sought to assess the immediate perioperative outcomes in the form of a pilot study, to determine whether this technique warrants further investigation in the form of prospective clinical studies.

Methods

The study team conducted a retrospective review of medical records for patients who underwent temporomandibular joint discectomy and replacement with AlloDerm© at a single tertiary care center, from 2011 to 2016. Perioperative outcomes of interest including pain levels and range of motion were recorded and descriptive statistics were utilized for statistical analysis.

Results

15 patients met the inclusion criteria, of which 87% were females and 13% males. The mean age was 47.27±15.93 years. Preoperatively, 74% of the patients reported severe pain (VAS scores of 7–10); in contrast, 73% of the patients reported only mild pain (VAS scores of 1–3) during the postoperative visits, suggesting an overall reduction in pain intensity. Range of motion also improved from an average of 27.73±13.04mm, to an average of 38.60±6.08mm (P<0.01).

Conclusions

Based on our preliminary data, patients with advanced TMJ articular disc disorders showed clinical improvement from discectomy and replacement with acellular dermal matrix (AlloDerm©). Further longitudinal studies evaluating long-term outcomes need to be conducted to validate this technique, in the form of larger sample sizes with a control group, as well as radiographic assessment of long-term clinical outcomes.

Le texte complet de cet article est disponible en PDF.

Plan


 The abstract of this article was presented at the joint American College of Oral and Maxillofacial Surgeons – Canadian Association of Oral and Maxillofacial Surgeons meeting in Vancouver, BC, Canada (May 2017).


© 2020  Publié par Elsevier Masson SAS.
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