J Kraeima1, B J Merema2, M J H Witjes3, F K L Spijkervet4. 1. Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700, RB Groningen, The Netherlands. Electronic address: j.kraeima@umcg.nl. 2. Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700, RB Groningen, The Netherlands. Electronic address: b.j.merema@umcg.nl. 3. Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700, RB Groningen, The Netherlands. Electronic address: m.j.h.witjes@umcg.nl. 4. Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700, RB Groningen, The Netherlands. Electronic address: f.k.l.spijkervet@umcg.nl.
Abstract
OBJECTIVES: Patients suffering from osteoarthritis, ankylosis (e.g. post-trauma or tumour) in the temporomandibular joint (TMJ) can present with symptoms such as severely restricted mouth opening, pain or other dynamic restrictions of the mandible. To alleviate the symptoms, a total joint prosthesis can be indicated, such as the Groningen TMJ prosthesis. This was developed as a stock device with a lowered centre of rotation for improved translational and opening capacity. This study aimed to improve the design of the prosthesis, and produce a workflow for a customized Groningen TMJ prosthesis, in order to make it more accurate and predictable. METHODS: The fossa and mandibular components of the Groningen TMJ prosthesis were customized. A series of five human cadavers was operated and bilateral TMJ prostheses were placed using custom cutting and drilling guides. Placement accuracy was evaluated based on post-operative CT data. RESULTS: A total of N = 10 prostheses were placed and analysed. The average Euclidean distance deviation from planned to actual position was 0.81 mm (SD 0.21). All prostheses were placed according to the routine surgical approaches and had an excellent alignment with the bony structures. CONCLUSION: The newly developed custom Groningen TMJ prosthesis can be placed with great accuracy and is the first step for improving TMJ total joint replacement surgery.
OBJECTIVES:Patients suffering from osteoarthritis, ankylosis (e.g. post-trauma or tumour) in the temporomandibular joint (TMJ) can present with symptoms such as severely restricted mouth opening, pain or other dynamic restrictions of the mandible. To alleviate the symptoms, a total joint prosthesis can be indicated, such as the Groningen TMJ prosthesis. This was developed as a stock device with a lowered centre of rotation for improved translational and opening capacity. This study aimed to improve the design of the prosthesis, and produce a workflow for a customized Groningen TMJ prosthesis, in order to make it more accurate and predictable. METHODS: The fossa and mandibular components of the Groningen TMJ prosthesis were customized. A series of five human cadavers was operated and bilateral TMJ prostheses were placed using custom cutting and drilling guides. Placement accuracy was evaluated based on post-operative CT data. RESULTS: A total of N = 10 prostheses were placed and analysed. The average Euclidean distance deviation from planned to actual position was 0.81 mm (SD 0.21). All prostheses were placed according to the routine surgical approaches and had an excellent alignment with the bony structures. CONCLUSION: The newly developed custom Groningen TMJ prosthesis can be placed with great accuracy and is the first step for improving TMJ total joint replacement surgery.