Load transfer in Christensen(®) TMJ in alloplastic total joint replacement for two different mouth apertures

This study analyses load transfer in the fossa component based on two numerical models of total temporomandibular joint (TMJ) implants for two mouth openings. The TMJ articulation is a very complex system with muscles, ligaments and cartilage. Until now, studies of TMJ implants have analysed only condylar behaviour. The finite element models were constructed based on CT scans of a cadaveric mandible and cranium, considering the bone geometry and position. The influence of five principal muscle actions was simulated for two mouth positions, 5 mm and 15 mm openings at the incisive tooth support. Strain distributions into the surrounding bone tissue were analysed in both models in the condyle and fossa components. The results demonstrate that in Christensen(®) TJR of the temporomandibular joint the fossa component is the more critical part, presenting more stress near the screw holes and contact regions with the cranium. The most critical region is around the first two screws and the least critical is in the condyle component. For the mandible condyle reconstructed with a Christensen(®) prosthesis, the 15 mm mouth opening was more critical, as compression was increased, but for the fossa component the most critical situation occurred with the 5 mm opening. The micromovements observed suggest that the number of screws could be reduced to increase osteointegration of screws in the mandible condyle.