L.WOLFORD'S TESTIMONY AND DOCUMENTED EVIDENCE ON TOXIC JAW IMPLANTS.
HUMAN LEUKOCYTE ANTIGEN STUDIES
The association of certain arthropathies with
an increased incidence of specific human leukocyte antigens (HLA) has been
demonstrated in well-controlled human studies. We have performed HLA typing
on 25 patients with TMJ dysfunction and failed PT implants to determine if an
increased incidence of HLA markers associated with a predisposition to
connective tissue and autoimmune diseases could be demonstrated. Most of the
patients were experiencing chronic pain and dysfunction. Medical histories of
the 24 female patients also included the following findings: 58 percent with
fibrocystic breast disease; 50 percent with hypersensitivity to metals; and
35 percent with endometriosis. Results showed that 10 of 25 patients (40
percent) had HLA-B locus antigens associated with psoriasis or psoriasis
arthritis, versus 17.6 percent of 125 controls. Other patients demonstrated
antigens associated with juvenile rheumatoid arthritis or sarcoidosis,
ankylosing spondylitis, Rieter's syndrome, and/or systemic lupus
erythematosus. If these findings are considered, then 20 of 25 patients (80
percent) have antigenic associations with various connective tissue diseases,
which may have predisposed them to immune dysfunction and treatment failure.
IMMUNOLOGICAL STUDIES
We have performed a preliminary study evaluating
immunological response to Proplast-Teflon implants in 12 patients. The total
lymphocyte count was calculated and immune response assessed by
immunophenotyping peripheral blood lymphocytes IS, CD2, CD3, CD4, CD8,
CD4:CD8 ratio, CD20, CD56, and surface Ig positive cells. The IA subset was
below controls in 73 percent of patients, and the CD4:CD8 ratio was decreased
significantly below the normal range. By contrast, the CD56 subset was
elevated in 60 percent of patients. An in vitro lymphocyte activation assay
was used with six patients to determine the presence of activated T-cells.
Lymphocytic activation was present in four of six patients. The activated
T-cell response was greater in those patients experiencing more severe
symptoms. The immunologic consequences of the activated T-cell response
remains to be investigated. (91)A small study followed four patients who had
a significant decrease in their immunodefiency panel prior to removal of the
PT implant. Three of the patients who had reconstruction with Techmedica
custom-made total joint prosthesis demonstrated a significant improvement
toward normal values at 1 year postsurgery.
SYSTEMIC DISEASES
Clinical observations suggest that some patients may have developed connective tissue
diseases that may have promoted or exacerbated by TMJ implant material. Some
conditions that have been recorder in TMJ patients with PT, Silastic, and
PMMA implants include chronic fatigue syndrome, chronic pain, impaired
cognition, short-term memory loss, lupus, psoriasis, psoriatic arthritis,
sarcoidosis, polyarthritis, fibromyalgia, human adjuvent disease, sclerderma,
Sjogren's syndrome, rheumatoid arthritis, visual disturbances, localized and
distant muscular disease, neurologic dysfunction, chronic low-grade fever,
generalized synovitis, and significant hormonal imbalances. Undifferentiated
or mixed connective tissue disease may be a common finding. Problems
associated with these conditions, especially chronic pain, physical
limitations, and diminished mentation often render these patients partially
or totally disabled. Foreign body giant cell granulomas have been found in
the TMJ, masticatory muscles, parotid and submandibular glands, regional
lymph nodes, on the roof of the orbit, within the orbit, in the lung, and in
breast biopsies. The extent of systemic involvement with alloplastic
materials remains unclear and requires further investigation.
HISOPATHOLOGIC DIFFERENCE OF ALLOPLASTIC
TEMPOROMANDIUBULAR JOINT IMPLANTS
Our series of patients suggests that foreign body giant cell reaction to PT implants is
proliferative and worsens with time, as more PT particles are generated.
Cartilage and bone degeneration and resorption occur. Heterotopic bone
formation and/or reactive neo-ossification can develop. It is unknown what
effects the aluminum oxide used in some PT implants has in the pathological
process. Silastic and PMMA particles appear to create a less proliferative
foreign body giant cell reaction. Cartilage and bone resorption can occur.
Particle size may be larger than the PT particles, resulting in fibrosis,
sometimes with reactive cartilage, neo-ossification, and/or heterotopic bone
formation. Local tissues may be affected by direct contact with the material
or leaching of monomer from the PMMA. Local reactions may in part be
chemically mediated from the polymers, from cells releasing substances in an
effort to degrade the polymers or upon cell death and lysis. Goldblum etal.14
identified antibodies to silicone. Unidentified antibodies may exist for
other polymers.
CONCLUSIONS
The local and systemic effects of Proplast-Teflon,
Silastic, and other polymeric implants undergo fragmentation and formation of
particulate debris are not clearly understood. Further studies will be
necessary to identify the effects of these materials, particularly in
patients who may have a predisposition to connective tissue and autoimmune
disease, and to develop treatment modalities that will predictably help the
unfortunate patients afflicted with these diseases.
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TMJD_SAFE_HAVEN_4_LIFE_ISSUES ยท TMJ SUPPORT GROUP
This TMJD Support Group is intended to be a Safe Haven and provide a place where people with TMJ pain can come and offer and receive support from people who know what they are going through. This is not a medical group and we do not have medical degrees or medical backgrounds. However, with the variety of members in here, there is bound to be someone who has been there and done that and can answer your questions.
This group is in memory of Debbie Ward whom suffered from TMJD & died of unknown causes.
There are many types of members with TMJD. Some have been treated medically, some treated with various splint therapies and physical therapies as well as some with surgical treatments ranging from Arthroscopy to full jaw joint replacements. Everyone with any degree of TMJD or has a family member that deals with it is welcome to join and offer and receive support that we all so badly need to get through each day with the pain we have to live with.
It is YOUR place to cry, scream or vent on the pain you are dealing with and how it is affecting your life and the lives of your loved ones. The group is MODERATED to avoid the unsolicited advertisements and spam. We are all in pain and do not need to have to deal with that too.
TMJ SURGERY FAMILY!.
A Great Place to Share Information! This site is for sharing and is not a substitute for the advise of your physician/oral surgeon. Please consult with your health care professional.
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