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Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication

2023-10-19Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Medicina Básica
datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
datacite.subject.sdg12:Produção e Consumo Sustentáveis
dc.contributor.authorÂngelo, David Faustino
dc.contributor.authorMaffia, Francesco
dc.contributor.authorTeschke, Marcus
dc.contributor.authorSanz, David
dc.contributor.authorGalrito, Marta
dc.contributor.authorCardoso, Henrique
dc.contributor.authorMarques, Rute
dc.contributor.authorNabuco, Carlos
dc.date.accessioned2026-10-19T12:55:13Z
dc.date.available2026-10-19T12:55:13Z
dc.date.issued2023-10-19
dc.description.abstractBackground: Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. Methods: A 65-year-old male patient was referred to Instituto Português da Face—Lisbon, Portugal—after failed attempts of mandibular reconstruction secondary to oral carcinoma resection and partial hemi-mandibulectomy plus radiotherapy of 60 total Grays. Primary reconstruction was performed with fibula free flap. Due to failure, secondary reconstructions were performed with osteosynthesis plate without success. The patient was unable to have adequate mastication and deglutition due to a severe crossbite. The authors treated the patient with an extended customized alloplastic temporomandibular joint replacement (F0M2). Results: With 3 years of follow-up, the patient showed an improvement in masticatory function, mandibular motion, pain levels, and overall quality of life. No complications were observed related to ATMJR. Conclusions: The presented case described how ATMJR, although not a validated option after radiotherapy, can be considered to restore functionality in complex cases with bone and soft tissues problems.eng
dc.identifier.citationÂngelo, D.F.; Maffia, F.; Teschke, M.; Sanz, D.; Galrito, M.; Cardoso, H.; Marques, R.; Nabuco, C. Considerations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indication. J. Clin. Med. 2023, 12, 6612. https://doi.org/10.3390/jcm12206612.
dc.identifier.doi10.3390/jcm12206612
dc.identifier.eissn2077-0383
dc.identifier.urihttp://hdl.handle.net/10400.8/17079
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://www.mdpi.com/2077-0383/12/20/6612
dc.relation.ispartofJournal of Clinical Medicine
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjecttemporomandibular joint
dc.subjecthead and neck neoplasms
dc.subjecttotal joint replacement
dc.subjectadjuvant radiotherapy
dc.subjectfree tissue flaps
dc.titleConsiderations for the Use of Alloplastic Temporomandibular Joint Replacement in Irradiated Patients: Report of an Off-Label Indicationeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage11
oaire.citation.issue20
oaire.citation.startPage1
oaire.citation.titleJournal of Clinical Medicine
oaire.citation.volume12
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameÂngelo
person.givenNameDavid
person.identifier.ciencia-id2C1B-F1D5-5A08
person.identifier.orcid0000-0001-8411-9946
relation.isAuthorOfPublication6d9ebcd1-9dd6-48a8-916d-3ca7b9c912eb
relation.isAuthorOfPublication.latestForDiscovery6d9ebcd1-9dd6-48a8-916d-3ca7b9c912eb

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Background: Custom-made alloplastic temporomandibular joint replacement (ATMJR) is not validated in irradiated patients. However, in specific situations, after previous reconstructive surgical failures, the authors hypothesized the role of a customized ATMJR after radiotherapy. Methods: A 65-year-old male patient was referred to Instituto Português da Face—Lisbon, Portugal—after failed attempts of mandibular reconstruction secondary to oral carcinoma resection and partial hemi-mandibulectomy plus radiotherapy of 60 total Grays. Primary reconstruction was performed with fibula free flap. Due to failure, secondary reconstructions were performed with osteosynthesis plate without success. The patient was unable to have adequate mastication and deglutition due to a severe crossbite. The authors treated the patient with an extended customized alloplastic temporomandibular joint replacement (F0M2). Results: With 3 years of follow-up, the patient showed an improvement in masticatory function, mandibular motion, pain levels, and overall quality of life. No complications were observed related to ATMJR. Conclusions: The presented case described how ATMJR, although not a validated option after radiotherapy, can be considered to restore functionality in complex cases with bone and soft tissues problems.
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