Abstract
Chronic pain is a possible long-term complication after alloplastic temporomandibular
joint reconstruction (TMJR). This study was developed to evaluate various subjective
and objective measurements to determine the presence and degree of TMJ pain in patients
with TMJR regardless of the operation indication. A prospective, single-center study
was performed. Data from 36 patients (56 TMJR) was collected preoperatively and at
follow-up 2-3 years postoperatively. The primary outcome variable was subjective TMJ
pain (no/mild, moderate/severe) at follow-up. The predictor variables were objective
pressure pain thresholds (PPTs at the ipsilateral joint(s) and muscle(s)) and functional
parameters (incisal range of motion; maximum voluntary clenching), subjective oHrQoL,
demographic and surgical variables. The number of patients with moderate/severe pain
decreased from 17 pre-operatively to 10 at follow-up. Self-reported TMJ pain was significantly
reduced in the entire group (p=.001). Patients with follow-up moderate/severe TMJ
pain were more restricted in their oHrQoL but did not differ in PPTs and functional
parameters from the no/mild group. Follow-up moderate/severe TMJ pain was associated
with unilateral TMJR and greater preoperative TMJ pain. This study provides preliminary
evidence that despite good pain reduction in most patients, persistent pain after
TMJR is common. In rare cases, pain may even worsen regardless of the original diagnosis.
At follow-up there was a close relation between oHrQoL and TMJ pain. TMJ pain after
TMJR cannot be confirmed by objective measurement methods (PPTs and functional parameters).
Keywords
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Article info
Publication history
Accepted:
March 8,
2023
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
