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Structural optimization of patient-specific temporomandibular joint replacement implants for additive manufacturing:novel metrics for safety evaluation and biomechanical performance

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Bio-Design and Manufacturing 2022年第2期5卷 333-347页

作者： Manuel Pinheiro Anouar Krairi Robin Willaert Maria C.Costa Wim Van Paepegem Mechanics of Materials and Structures(MMS) Ghent UniversityGhentBelgium Materials Innovation Institute(M2i) DelftThe Netherlands Department of Oral and Maxillofacial Surgery University Hospitals Leuven LeuvenBelgium 4 Department of Head and Neck SurgeryGhent University HospitalGhentBelgium

Total temporomandibular joint(TMJ)replacement is recommended only when there is irreversible damage to the joint and no conservative treatment can provide functional *** stock and custom-made TMJ implants have been made available;however,retrospective and comparative studies were unable to find significant differences between the two types of *** introduction of additive manufacturing(AM)techniques in medical practice allows for a greater freedom of design and a higher degree of device *** combination of AM with structural optimisation may streamline development and provide the key for fabricating biomechanic ally enhanced TMJ *** this study,structural optimis ation techniques were applied to develop and numerically validate a patient-specific TMJ *** biomechanical behaviour of each intermediate TMJ design was assessed under four different nominal and maximum biting tasks using finite element *** addition,a new set of metrics were proposed to compare each design regarding biomechanical performance and implant *** results suggest that 55-82%of the natural/intact strain patterns can be recovered with the finally selected TMJ *** represents an increase of 15%in biomechanical performance for incisor biting,15%for right molar biting,17%for left molar biting and a decrease of 2%for left group biting compared with the initial *** results also suggest that load transfer at the proximal ramus reduces the implant’s impact on the mandible’s strain ***,structural optimisation allows for a volume reduction of up to 44%with a minimum loss of implant safety and biomechanical performance.

关键词： temporomandibular joint Additive manufacturing Implant safety Biomechanical performance Finite element analysis

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Distribution of pericellular matrix molecules in the temporomandibular joint and their chondroprotective effects against inflammation

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International Journal of Oral Science 2017年第1期9卷 43-52页

作者： Wern Cui Chu Shipin Zhang Timothy J Sng Yu Jie Ong Wen-Li Tan Vivien Y Ang Casper B Foldager Wei Seong Toh Faculty of Dentistry National University of SingaporeSingapore Orthopaedic Research Laboratory Aarhus University HospitalAarhusDenmark Tissue Engineering Program Life Sciences InstituteNational University of SingaporeSingapore

The objectives of this study were to （1） determine the distribution and synthesis of pericellular matrix （PCM） molecules （collagen VI, collagen IV and laminin） in rat temporomandibular joint （TMJ） and （2） investigate the effects of PCM molecules on chondrocytes against inflammation in osteoarthritis. Four zones （fibrous, proliferating, mature and hypertrophic） of condylar cartilage and three bands （anterior, intermediate and posterior） of disc were analysed by immunohistochemistry for the presence of PCM molecules in rat TMJs. Isolated chondrocytes were pre-treated with PCM molecules before being subjected to interleukin （IL）-II~ treatment to stimulate inflammation. The responses of the chondrocytes were analysed using gene expression, nitric oxide release and matrix metalloproteinase （MMP）-13 production measures. Histomorphometric analyses revealed that the highest areal deposition of collagen VI （67.4%）, collagen IV （45.7%） and laminin （52.4%） was in the proliferating zone of TMJ condylar cartilage. No significant difference in the distribution of PCM molecules was noted among the three bands of the TMJ disc. All three PCM molecules were expressed intracellularly by chondrocytes cultured in the monolayer. Among the PCM molecules, pre-treatment with collagen VI enhanced cellular proliferation, ameliorated IL-lp-induced MMP-3, MMP-9, MMP-13 and inducible nitric oxide synthase gene expression, and attenuated the downregulation of cartilage matrix genes, including collagen I, aggrecan and cartilage oligomeric matrix protein （COMP）. Concurrently, collagen VI pretreatment inhibited nitric oxide and MMP-13 production. Our study demonstrates for the first time the distribution and role of PCM molecules, particularly collagen VI, in the protection of chondrocytes against inflammation.

关键词： cartilage chondrocytes collagen iV collagen W inflammation laminin pericellular matrix temporomandibular joint

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A study of the temporomandibular joint during bruxism

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International Journal of Oral Science 2014年第2期6卷 116-123页

作者： María S Commisso Javier Martínez-Reina Juana Mayo Department of Mechanical Engineering University of Seville Seville Spain

A finite element model of the temporomandibular joint （TMJ） and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained （awake bruxism） or cyclic loading （sleep bruxism） is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.

关键词： bruxism finite element simulation temporomandibular disorder temporomandibular joint

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Calcium pyrophosphate deposition disease of the temporomandibular joint invading the middle cranial fossa:Two case reports

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World Journal of Clinical Cases 2021年第11期9卷 2662-2670页

作者： Ting Tang Fu-Gang Han Department of Radiology The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina

BACKGROUND Pseudogout is a benign joint lesion caused by the deposition of calcium pyrophosphate dihydrate crystals,but it is *** of the temporomandibular joint(TMJ)is uncommon,and it rarely invades the skull base or penetrates into the middle cranial *** disease has no characteristic clinical manifestations and is easily *** SUMMARY We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa.A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal *** patient,a 52-year-old man with a mass in the left TMJ for 6 years,was admitted to the *** imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ *** patients underwent excision of the *** lesion was pathologically diagnosed as tophaceous *** symptoms in these patients were relieved after *** Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction.A pathological examination is the gold standard for diagnosing this *** treatment is currently the recommended treatment,and the prognosis is good after surgery.

关键词： Tophaceous pseudogout temporomandibular joint Middle cranial fossa Calcium pyrophosphate deposition disease Case report

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Evaluation of the temporomandibular joint in Class Ⅰ,Ⅱ, and Ⅲ Hyperdivergent Patients:A Comparative Study by Three-dimensional Cone-beam Computed Tomography

Evaluation of the Temporomandibular Joint in Class Ⅰ,Ⅱ, an...

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作者： Bimal Panthi 南京大学

学位级别：硕士

[Objective]To evaluate the joint spaces and condylar morphology among different vertical skeletal patterns to compare condylar position and morphology.[Materials and Methods]Diagnostic cone-beam computed tomography images of 80 adult patients (160 temporomandibular joints) who visited the Department of Orthodontics, Affiliated Stomatology Hospital of Medical School, Nanjing University were evaluated using Mimics 16.0 software. The subjects were divided into four equal groups based on angles classification and Frankfurt Horizontal plane-Mandibular plane Angle. Group Ⅰ included skeletal Class Ⅰ normodivergent patients whereas Group Ⅱ, Ⅲ, and Ⅳ were skeletal Class Ⅰ, Ⅱ and Ⅲ hyperdivergent patients respectively. temporomandibular joint spaces, depth of mandibular fossa and condylar morphology and asymmetry were compared among the groups.[Results]*** difference values were seen in the anteroposterior diameter of condylar process on right (p=0.005) and left (p=0.011) side, mesiolateral diameter of condylar process on left (p=0.008) side, lateromedial plane angle of condylar process right (p=0.004) and left (p=0.00) side, axial condylar angle right (p=0.011) and left (p=0.001) side and the anteroposterior difference of the condylar processes (p=0.002) among all the four groups i.e. class Ⅰ normodivergent group and class Ⅰ, Ⅱ and Ⅲ hyperdivergent groups.2. Anterior joint space on both right (p=0.037) and left (p=0.04) side, superior joint space on left (p=0.30) and posterior joint space on both the right (p=0.013) and left (p=0.01) sides were found to be significantly different. This data suggest that the condyles in class Ⅱ hyperdivergent patients are nonconcentric than the class Ⅰ hyperdivergent patients.3. The mean anteroposterior diameter of the class Ⅱ hyperdivergent patients was R=4.33±1.56, L=4.24±1.64 and class Ⅰ hyperdivergent was R=5.37±0.84, L=5.25±1.24. The mean mesiolateral diameter of the class Ⅱ hyperdivergent group was R=10.90±3.23, L=10.00±2.84 a

关键词： Cone Beam Computed tomography (CBCT) temporomandibular joint Condylar morphology Condylar axial angle Hyperdivergent

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Clinical Evaluation of Platelet Rich Growth Factors (PRGFS) in Treatment of temporomandibular joint Disc Displacement—Study Report

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Open Journal of Stomatology 2023年第5期13卷 174-187页

作者： Lahaou Baladji Touré Oumar Ongoïba Djibril Kassogué Wael Ahmed Elmohandes Elsaeed Mohamed Abdellatif Department of Surgery Regional Hospital of Tombouctou Tombouctou Mali Department of Oral and Maxillofacial Surgery Faculty of Dental Medicine Al Azhar University Cairo Egypt

Objective: The aim of the study was to evaluate the effect of platelet rich growth factors (PRGFs) in treatment of temporomandibular joint disc displacement. Materials and Methods: The study subjects included 8 females having bilateral anterior disc displacement with reduction and 1 female having bilateral anterior disc displacement without reduction with the age range between 20 - 35 years. The process of obtaining PRGFs was carried out following the Anitua Technique. Results: Clinical parameters of Interincisal distance, Lateral excursion of mandible using digital caliper in millimeters and Visual Analogue Scale (VAS 0/10) for pain intensity score were used. All of these parameters were running through the intervals of two, four, and eight weeks till the end of the follow-up period at twenty-six weeks (six months). The participated patients showed the clinical improvement in the different clinical statuses such as interincisal distance;lateral excursion of mandible and Pain Score. Conclusion: the study reported early efficacy of PRGFs after the arthrocentesis of the joint in treatment of TMJ disc displacement, and according to our results, the injection of PRGFs could be a possible alternative treatment for patients who did not respond to standard treatment.

关键词： Platelet Rich Growth Factors Platelet Rich Plasma temporomandibular joint

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THE EXPERIMENTAL STUDY ON SURGICAL TREATMENT OF temporomandibular joint ANKYLOSIS USING FREE ALLOLOGOUS COSTAL PERICHONDRIAL GRAFTS IN RABBITS

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Journal of Pharmaceutical Analysis 1998年第1期12卷 54-60页

作者：孙健赵文清胡永升李宁毅

The growth of newborn cartilage ih 12o days following the allograft of free costal Pc tothe hone section or TMJ condyle was studied. Light microscope, electron microscope, biochemistryanalysis, and PCNA immune chemo-staining were used to make mobile observation and analysis ifthe changes in the new catilage's tissue structure, GA and collaged content. The results indicate asfollows: 07The transplanted homologous PC excaped observable immune repulsion so that it couldsurvive to form new joint cartilage with approxlmste normal tissue structure and biochemistry constitution j @The reproduction process was similar to the normal one, hut ovas prolonged a little. ':J)Withexcellent form structure and biology mechanical functions, the new cartilage was able to meet the requirement of TMJ, and successfully prevent the adhenslon of the bone section, as 'veil as biologicallyrebuild TMJ: @ In the later stage, the degeneration and calclfication in hasal layer increased. however, due to its limited scope, no apparent efrect on the cartilage growth and function was observed.

关键词： temporomandibular joint allograft perichondrium

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Internal derangement of temporomandibular joint: role of arthocentesis with steriod

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Plastic and Aesthetic Research 2014年第1期1卷 29-32页

作者： Altaf Hussain Malik Department of Oral and Maxillofacial Surgery Govt Dental CollegeUniversity of KashmirHazratbalSrinagar 190006J&KIndia.

Aim:The aim of this study was to compare the efficacy of arthrocentesis with arthrocentesis plus steroid in the treatment of temporomandibular joint(TMJ)internal ***:Nine males and 11 females aged 17–39 years were enrolled in the *** patients were complaining of limited mouth opening and TMJ *** was performed under aseptic *** patients were clinically evaluated before the procedure,and 1 week and 6 months after the *** of TMJ pain and maximal mouth opening was recorded at each follow-up ***:Both groups showed significant improvement in mouth opening and a reduction in pain scores in the postoperative period;however,the addition of steroid did not improve the overall outcome of the ***:Arthrocentesis is a simple and safe procedure for patients with internal derangement of the TMJ with closed ***,the outcome was not improved by the addition of steroid.

关键词： Arthrocentesis internal derangement steroid temporomandibular joint

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Treatment of chronic recurrent dislocation of temporomandibular joint by autologus blood injection

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Plastic and Aesthetic Research 2016年第1期3卷 121-125页

作者： Syed Sayeed Ahmed Md.Kalim Ansari Department of Oral and Maxillofacial Surgery Dr.Ziauddin Ahmed Dental CollegeAligarh Muslim UniversityAligarh 202002India

Aim:The aim of this study was to evaluate the efficacy of autologus blood injection in the management of recurrent temporomandibular joint(TMJ)***:A total of 11 patients,4 males,7 females,mean age of 58.6 years and suffering from recurrent dislocation of TMJ,were included in the *** all the patients the procedure included anesthesia-local or sedation,arthrocentesis which was followed by autologous blood injection in the upper joint *** peri-articular tissues were also infiltrated with autologous *** procedure advice included restricted mouth activity and liquid diet for a ***:The results indicate that success rate of treatment of recurrent dislocation of TMJ is 72.8%which can be considered as *** recurrence was noticed in 27.2%cases after one year follow ***:Autologus blood injection is an effective,simple,non-invasive,and safe procedure for treatment of recurrent dislocation of TMJ and can be performed on outpatient basis.

关键词： Subluxation recurrent dislocation arthrocentesis temporomandibular joint autologous blood

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Pigmented Villonodular Tenosynovitis of the temporomandibular joint—A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2016年第1期5卷 34-37页

作者： Satinder Singh Iram Khan Shalabh Sharma Asish K. Lahiri Department of ENT Sir Ganga Ram Hospital New Delhi India

Background: Pigmented villonodular synovitis is a rare condition typically affecting the major joints and the involvement of the temporomandibular joint is rare. Although, it is histologically benign, it can be locally aggressive, capable of extensive bone destruction. The disease has aggressive behavior and a high incidence of recurrence (40% - 60%). Case report: A 35 years old male presented with history of unilateral hearing loss and otalgia of six month duration. On examination, there was a soft bulge in the superior wall of external auditory canal. Contrast enhanced CT scan showed soft tissue density occupying the right external auditory canal and bulging into the middle ear cavity, displacing the intact ossicular chain medially with evidence of destruction of the posterior wall of the external auditory canal, glenoid fossa, mastoid bone and the scutum. The squamous part of the right temporal bone showed evidence of lateral bowing with discontinuity. Surgical resection was done through post aural approach. Histopathological examination revealed pigmented villonodular tenosynovitis which stained positive for CD 68. Post operatively patient was evaluated clinically and with radiological modalities which showed healthy mastoid cavity and no increase in post operative granulations on magnetic resonance imaging. Conclusion: Pigmented villonodular tenosynovitis of temporomandibular joint is a rare entity. Due to the aggressive behavior of the lesion, radical or aggressive surgical resection should be done. Long term follow up with radiological modality should be done due to the high recurrence rate.

关键词： Pigmented Villonodular Synovitis temporomandibular joint Giant Cell Granuloma Synovitis

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