Update on the Vitek partial and total temporomandibular joint systems

A retrospective recall study was done on 262 VK I (N = 138) and VK II (N = 124) (Vitek, Inc, Houston, TX) partial and total temporomandibular joints placed between 1982 and 1990. The cumulative success rate of VK I total joints observed for up to 10 years was approximately 20%, whereas the success rate of VK II total joints observed up to 6 years was approximately 80%. At the 5- to 6-year interval for each, these rates were 44% and 79%, respectively. Wear of the Teflon fluorinated ethylene propylene polymer surface was the primary reason for VK I failure; there was no material failure of the VK II prostheses. Slightly better pain relief, increase in interincisal opening, improvement in diet, and greater overall satisfaction were noted with the use of VK II. A highly significant improvement in success data was found if no surgery had been performed before either VK I or VK II total joint placement. Rib grafts were not particularly helpful after removal of total joint prostheses, particularly if the patient had a history of multiple surgeries. Total temporomandibular joint surgery must be reserved for patients in whom alternative surgical methods have failed or are no longer indicated. All total joint implants, particularly the VK I, must be observed closely with clinical examination and imaging and removed at the earliest sign of material failure.