Abstract
Temporomandibular joint replacement (TMJR) is a complex surgical procedure in which the artificial joints available must assure the anatomical reconstruction and guarantee a good range of the natural temporomandibular joint (TMJ) movements. With this aim, different types of TMJ prostheses, including the stock prosthetic system and custom‐made prostheses, are being currently implanted. Although temporomandibular joint replacements (TMJRs) are expected to accomplish their function during a number of years, they might actually fail and need to be replaced. This paper analyzes different design factors affecting the contact stress distributions within the TMJ prosthesis interface, which are consequently involved in their deterioration and final failure of the prosthetic device. With this purpose, a numerical model based on finite elements has been carried out in order to evaluate the stress states attained in different prosthesis configurations corresponding to general types of TMJ prostheses. On the other hand, the actual degradation of resected implants has been evaluated via optical microscopy. The linkage between the numerical simulations performed and experimental evidence allowed the authors to establish the different wear and damage mechanisms involved in the failure of stock TMJ prostheses. Indeed, the results obtained show that the contact stresses at the interface between the mandible and the glenoid fossa components play a key role in the failure process of the TMJR devices.
Highlights
Medical prostheses are artificial devices used to replace the main function of damaged human tissues. is damage can occur as a result of degenerative diseases, traumatic accidents, or tumours
For the last few decades, the scientific community and industrial companies have been focusing on the study and development of a new kind of prosthesis [1] especially for bones and their joints [2, 3], mainly based on the use of groundbreaking manufacturing technologies such as additive manufacturing [4, 5] or other innovative machining technologies [6] and forming processes [7,8,9]. ese approaches have been carried out from different points of view including medical, engineering, and industrial perspectives, being the principles of multidisciplinary approaches essential for the final purpose of the design and the manufacturing of even more successful devices to be implanted
0.22 0.06 of the superior circular surface is constrained. e cranial bone is not considered in the analysis as far as from a medical point of view; from the inspection of this zone, there are no appreciable damage [13, 17] due to the correct prosthesis biointegration usually attained after surgical procedure
Summary
Medical prostheses are artificial devices used to replace the main function of damaged human tissues. is damage can occur as a result of degenerative diseases, traumatic accidents, or tumours. Taking into account this background, the use of suitable biomaterials [18] and numerical methods [19, 20] for increasing knowledge of stress/strain states in the TMJ prosthesis interface should lead to the correct design parameters [21] that could decrease material wear and increase the longevity of joint replacement devices.
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