Clinical and radiological outcomes of Chinese customized three-dimensionally printed total temporomandibular joint prostheses: A prospective case series study

Abstract

Temporomandibular joint (TMJ) diseases are highly prevalent in China. However, no commercialized custom-made prostheses are available now. This study introduces a three-dimensionally (3D) printed customized total TMJ prosthesis manufactured by a standardized workflow. Consecutive patients with end-stage TMJ diseases were recruited from Jan 2018 to Sep 2018. The computed tomography (CT) data for patients were obtained and transformed into the Mimics 18.0 software preoperatively for designing of prostheses and digital templates. 3D printing, friction spot welding and computer-assisted manufacture (CAM) were used to fabricate different components of the prosthesis. The clinical and radiographic evaluations were performed postoperatively. A series of 9 patients were included. All the prostheses were placed smoothly and fixed stably during surgical procedure. Without severe postoperative complications, all patients exhibited significant improvements in maximum mouth opening, pain, diet, and mandibular function, with good facial symmetry. For the whole prosthesis, the average mean deviation was 0.432 mm (range: from 0.279 to 0.561 mm). This study suggests that Chinese customized 3D-printed total TMJ prostheses produces excellent short-term clinical outcomes, with high accuracy in implantation.