Date sent:      	Sun, 8 Dec 2002 

Clinical evaluation of patients with temporomandibular joint implants.

J Oral Maxillofac Surg 2002 Dec;60(12):1389-1399

Ta LE, Phero JC, Pillemer SR, Hale-Donze H, McCartney-Francis N, Kingman A,
Max MB, Gordon SM, Wahl SM, Dionne RA.

Postdoctoral Fellow, Pain and Neurosensory Mechanisms Branch, National
Institutes of Health, Bethesda, MD., dagger Professor, Department of
Anesthesia, University of Cincinnati Medical Center, Cincinnati, OH.,
double dagger Staff Clinician, Gene Therapy and Therapeutic Branch,
National Institutes of Health, Bethesda, MD., section sign Postdoctoral
Fellow, Oral Infection and Immunity Branch, National Institutes of Health,
Bethesda, MD., parallel Staff Scientist, Oral Infection and Immunity
Branch, National Institutes of Health, Bethesda, MD., paragraph sign Staff
Scientist, Biostatistics Core, National Institute of Dental and
Craniofacial Research, Bethesda, MD., #Senior Investigator, Pain and
Neurosensory Mechanisms Branch, National Institutes of Health, Bethesda,
MD., Staff Scientist, Oral Infection and Immunity Branch, National
Institutes of Health, Bethesda, MD., dagger dagger Chief, Oral Infection
and Immunity Branch, National Institutes of Health, Bethesda, MD., double
dagger double dagger Chief, Pain and Neurosensory Mechanisms Branch,
National Institutes of Health, Bethesda, MD.

PMID: 12464999


PURPOSE: An undetermined number of patients with temporomandibular joint
(TMJ) symptoms have been treated with intra-articular disc implants
composed of Teflon ethylene/propylene or Teflon polytetrafluoroethylene and
aluminum oxide (Proplast-Teflon; Vitek, Houston, TX). These implants have
shown the potential to fragment in situ resulting in nonbiodegradable
particles that stimulate a giant cell reaction and lead to degeneration of
local structures, pain, and limitation of mandibular opening. We examined
the possible relationship between TMJ implants and persistent pain,
responses to sensory stimuli, quality of life, and systemic immune
dysfunction.

PATIENTS AND METHODS: This case series (32 patients) were referred from
university-based orofacial pain centers and private practices from across
the United States. Laboratory and clinical assessments evaluated orofacial
pain symptoms, neurologic function, clinical signs and symptoms of
rheumatologic disease, physical function, systemic measures of immune
function, and behavioral measures.

RESULTS: We found that TMJ implant patients appeared to have altered
sensitivity to sensory stimuli, a higher number of tender points with a
diagnosis of fibromyalgia, increased self-report of chemical sensitivity,
higher psychologic distress and significantly lower functional ability.
Systemic illness or autoimmune disease was not evident in this series of
TMJ implant patients.

CONCLUSIONS: Significant problems were noted on clinical assessment of TMJ
implant patients.


This is a US government work. There are no restrictions on its use. J Oral
Maxillofac Surg 60:1389-1399, 2002