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Artificial Jaw Implant Catches On; Could Eventually Assist Millions

February 07, 1988|United Press International

NEW YORK — An artificial implant that helps restore function in the jaw is becoming increasingly popular and doctors say it may someday be as common as artificial hip implants.

"Studies have shown about 30 million people suffer from some degree of jaw dysfunction," said Dr. Kevin McBride, a Dallas plastic surgeon who has implanted 80 of the devices.

"Not all of them are in enough pain or have enough dysfunction to warrant an implant, but it goes to show how common this problem is," he said. "It is potentially much more widespread than hip dysfunction."

The artificial implant was a godsend for Rita O'Neil, a Texas resident and mother of three, whose jaw was severely dislocated in a serious car accident three years ago.

"For months afterward, I was in such extreme pain that I couldn't sleep," O'Neil said in a report to the TMJ Foundation, a Los Angeles-based organization that promotes medical advances in the treatment of jaw dysfunction.

"I could just barely open my mouth to eat soft foods like soup and mashed potatoes," she said. "My speech was garbled."

The accident had left O'Neil with a severe case of temporomandibular joint pain dysfunction syndrome, or TMJ, a common disorder in which the jaw is not able to open and close naturally.

The constant stress on her badly aligned jaw eventually caused bone in the joint to deteriorate, according to McBride.

He replaced the entire damaged jaw joint with the implant, which is similar to implants used to replace badly broken and deteriorated hips.

The device, made from a plastic material that will not be rejected by the body's immune system, replaces a malfunctioning jaw joint with a new ball and socket.

"It is a device of last resort when lesser procedures just don't provide the relief that's needed," McBride said of the implant, which has been on the market only a couple of years.

He said installing the device means cutting and removing segments of the jaw, but that "they are usually so deteriorated at that point" that it is the only effective measure.

The socket and ball implant is fastened onto the remaining jawbone after being inserted through an incision made around the ear, "much like a face lift," said McBride.

"We can't go through the mouth because of the risk of infection," he said.

A skillful plastic surgeon can implant the device without altering the appearance of the patient, but McBride said it is sometimes necessary or desirable to build up the lower jaw through the operation.

The constant bone deterioration that can accompany TMJ may cause the lower jaw to shrink in relation to the upper jaw, giving the face an unbalanced look, doctors say.

After the operation, patients may not be able to open their mouths as wide as they could before, McBride said. Other than that, complications appear to be minimal.

McBride and spokesmen for the TMJ Foundation say only a handful of oral and plastic surgeons are now capable of implanting the jaw devices. However, the company that manufactures the device is sponsoring training seminars for doctors interested in learning the technique.

According to the foundation, some 20 million Americans suffer from TMJ syndrome, although only a small percentage are considered candidates for the implant procedure.

In its usual form, TMJ causes pain and discomfort. At its worst, the syndrome can be painfully debilitating, with patients unable to open their mouths more than a fraction of an inch.

The syndrome's hallmark is an audible clicking noise that can be heard when the jaw opens and shuts, doctors say. The click is caused when the jaw joint slides in and out of its socket.

Doctors say that more women than men suffer from the syndrome, most of them between the ages 18 and 35. It is often caused by damage to the jaw in a fall or accident, but the syndrome can also occur in people who grind or clench their teeth because of stress or people who have had orthodontic work.

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