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Temporomandibular Joint Prostheses: Optimal Materials for the Optimal Stomatognathic System Performance-Preliminary
Iwona Niedzielska1, Michał Bąk1, Damian Niedzielski1
1Department of Cranio-Maxillo-Facial Surgery, Medical University of Silesia in Katowice, ul. Francuska 20-24, 40-027 Katowice, Poland.
Journal of Functional Biomaterials
|February 3, 2021
Summary
Temporomandibular Joint (TMJ) prostheses significantly limit jaw movement compared to patient-specific implants. Further development in TMJ prosthesis design and materials is crucial for improved patient outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Biomedical Engineering
- Biomechanics
Background:
- Temporomandibular Joint (TMJ) disorders require effective treatment modalities.
- Alloplastic TMJ prostheses are one option, but their impact on jaw kinematics needs quantitative evaluation.
- Comparison with other surgical interventions like patient-specific implants (PSI) and condylectomy is essential.
Purpose of the Study:
- To quantitatively compare jaw kinematics in patients with TMJ prostheses versus those treated with PSI or condylectomy.
- To assess the functional outcomes of different TMJ treatment approaches.
Main Methods:
- Axiography (Cadiax Compact 2) was used for noninvasive, three-dimensional condylar movement analysis.
- Clinical evaluation of mandibular movements was performed on six patients with TMJ prostheses, four with PSI, and four post-condylectomy.
- Statistical analysis included Kruskal-Wallis and Dunn's post hoc tests.
Main Results:
- Patients with TMJ prostheses exhibited significant bilateral jaw movement limitations.
- Protrusion movement vector length was markedly reduced in TMJ prosthesis patients (0.31 mm) compared to PSI patients (3.01 mm).
- Laterotrusion to the operated side also showed reduced movement in TMJ prosthesis patients (0.66 mm) versus PSI patients (3.35 mm).
Conclusions:
- Current alloplastic TMJ prostheses lead to significant jaw kinematic deficits.
- Patient-specific implants with condylar head preservation demonstrate superior jaw mobility.
- Advancements in TMJ prosthesis geometry and materials are necessary to enhance functional restoration.
