Vitek Case's!
The TMJ, just in front of the ear, would seem to be a = simple hinge, but since you can move your lower jaw from side to side = and back and forwards a little, it is not so simple. Even in opening and = closing there is both rotation and sliding movement at the joint. See = the joint and a quicktime movie of the motion.
TMD - dysfunction of the TMJ can have all sorts of = symptoms, from the obvious pain in the joint, pain on chewing and = limited jaw movement to headaches, ringing in the ears, back pain and = malocclusion - problems with teeth not matching up in the bite.
There is a new prosthesis being tried out that is based = on the successful hip ( and knee). It has a titanium extension to the = jaw and a UHMW PE cup in the cranial bone. Because everything is on so = much smaller a scale, this device calls for a scan to determine the = shape of your bones, and a joint replacement made to fit you. At = present a plastic skull and jaw is created from the scan and the joint = is test fitted to it before the operation. This sounds good, but it = has not been is trial long enough to tell.=20 =20
=20 A simpler device that does not have to be built for each = patient is entirely constructed of Co-Cr, and if both sides of the joint = are replaced, relies on metal-metal contact. It has a longer track = record of success... the suppliers claim that its failures are often = because it is used as the last resort, after 5-10 previous operations.=20 =20
The "bad joint" label comes from the failure of a number of = previous attempts to produce a replacement. The most notorious of these = is the 'interpositional implant' make by Vitek, using a PTFE, carbon and = alumina porous composite called Proplast and FEP (fluorinated ethylene = plastic) film. These joints have or are expected to fail completely, = releasing PTFE fragments that cause extensive bone erosion and severe = inflammation due to giant cell foreign body response. The bone erosion = can be severe enough to cause leakage of cerebrospinal fluid.
=20 It is quite difficult to find the exact nature of = Proplast, and I do not have a sample; although it was recently made in = Europe, FDA rules require immediate confiscation of any imported = material - part of the most severe type of recall. In fact most = detailed reports are to be found in review articles in facial surgery = journals and in reports of legal proceedings. One legal report site has = an associated full text for download in an .rtf file (rich text format). = !! warning !! printing this rtf file (from Word, for example) will take = over 100 pages=20
I have summarized this document as tmjsumry.rtf and you ftp = it from here. CHECK THIS OUT. =20
=20 From the summary you will see that Charles Homsy wanted = DuPont to make medical devices from PTFE. They said no thanks, it won't = be profitable (for a company set up to deal in large volumes) and the = Legal department doesn't like the liability risks. So he left, and = began designing and making devices. When he ordered PTFE Du Pont wrote = telling him that it was not approved for medical use, that any problems = would be his responsibility, and quoted the bad experience of Dr. = Charnley. When he signed a disclaimer, they shipped the plastic. When = he wanted more, they warned him again. It is difficult to see what else = they should have done, but this did not stop them from being sued over = 65 times, and incurring >$40M in legal costs.=20
Much of the litigation deals with whether DuPont should have = relied on Vitek (as experts) to warn the end-users of the dangers, or = should have warned them directly. Previous cases involving pool liners, = bridges and flammable solvent used in a washing machine are all thought = possibly relevant in this regard.
=20 A lawyer's view on TMD is interesting, but is mostly = concerned with personal injury claims - tmj problems caused by whiplash. It = describes " how to win before you start" a guide to choosing the right = jury.
Copyright David Grubb 1998, 1999
Copyrighted By Angels United On TMJ!
Can not be placed on any other web site or any support groups without:
the written permission of ANGELS UNITED ON TMJ!
"COPYRIGHT Feb. 2001" By Angels United On TMJ!
ANGELS UNITED IS UN-COVERING THE TRUTH ON TMJ!
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WE ARE ANGELS UNITED ON TMJ!
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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