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Clinical application of our developed artificial temporomandibular joint. 1)study on respiratory function, especially sleep apnea syndrome, 2)study on jaw movement

我们研制的人工颞下颌关节的临床应用。

基本信息

批准号：
10470433
负责人：
SUGAHARA Toshio
金额：
$ 8.64万
依托单位：
OKAYAMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B).
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 2000
项目状态：
已结题

项目摘要

After considering three-dimensional morphometry, stress analysis, strength, abrasion resistance of human temporomandibular joints (TMJ), we have developed an artificial TMJ only in this country. We aimed to carry out real clinical application of this artificial TMJ, and to make it advanced prothese based on analysis of effects on chewing, phonation, swallowing, respiration and facial morphological change.1) The total replacement of the artificial TMJ was applied to the patients who were affected by chronic rheumatoid arthritis and whose TMJs were destroyed. All patients were doing well, and the results were sufficiently satisfactory as respect to function and form. Destroyed artificial TMJs were designed, and stress analysis in the clinic and simulation of jaw movement were carried out using finite element analysis.2) Jaw movement after the total replacement of TMJ was investigated using kinegiography. In comparison with healthy subjects, jaw movement in the patients with deformative a … More rthrosis was obviously restricted. After the surgery, it was confirmed that the opening quantity increased and that the masticatory efficiency heightened. However, anterior and lateral shift was limited. Some patients could not gain the opening quantity sufficiently, and in the patients atrophy of the opening muscle was observed using ultrasound image. The apnea over 60 seconds in the sleep disappeared in all patients.3) The mandible was deformed and transferred by the deformative jaw arthritis, and the antero-posterior diameter of the upper respiratory tract was then observed. It was clarified that the antero-posterior diameter of the upper respiratory tract was improved following to the surgery. However, the antero-posterior diameter of the upper respiratory tract tended to slightly decrease in postoperative 1-2 years. Although it was not clear on this cause, respiratory condition did not become worse.4) The effects on respiration following to the surgery : Respiratory conditions, ex. air-flowand oxygen saturation, in the patients with deformative arthrosis were analyzed quantitatively using apnea-monitor (Eden Trace). Consequently, it was shown that the respiration in the patients was improved.5) After two-and three-dimensional stress analysis was carried out using three-dimensional finite element analysis, the artificial TMJ with more strength was designed and made.6) To facilitate the mounting of artificial TMJ in the surgery and to raise the functionality of the artificial TMJ more and more, we have started in designing of the artificial TMJ of custom maid whom the patient individually suits. Less

本研究综合考虑人体颞下颌关节的三维形态测量、应力分析、强度、耐磨性等因素，研制了国内唯一的颞下颌关节人工关节。本研究旨在进行真实的临床应用，并通过对咀嚼、发声、吞咽、呼吸及面部形态改变的分析，使其成为一种先进的人工颞下颌关节假体。1）对慢性类风湿关节炎患者的颞下颌关节进行全关节置换。所有患者均表现良好，功能和形态方面的结果均令人满意。设计破坏性的人工颞下颌关节，利用有限元分析方法进行临床应力分析和下颌运动模拟。2）利用运动学方法研究全颞下颌关节置换术后下颌运动。与正常人相比，畸形性颌骨畸形患者的颌骨运动 ...更多信息关节炎明显受限。手术后，证实了开口量增加，咀嚼效率提高。然而，前向和侧向移位有限。部分患者不能获得足够的开口量，并且在患者中使用超声图像观察到开口肌肉萎缩。所有患者睡眠呼吸暂停时间均超过60 s，均消失。3）通过变形性颌骨关节炎造成下颌骨变形移位，观察上呼吸道前后径。明确了手术后上呼吸道的前后径得到改善。术后1-2年上呼吸道前后径有轻度缩小趋势。虽然原因尚不清楚，但呼吸状况并未恶化。4）手术后对呼吸的影响：呼吸状况，例如。应用呼吸暂停监测仪（Eden Trace）对变形性关节病患者的空气流量和血氧饱和度进行定量分析。5）通过三维有限元分析进行二维和三维应力分析，设计并制作了强度更高的人工颞下颌关节。6）为方便手术中人工颞下颌关节的安装，进一步提高人工颞下颌关节的功能性，我们已经开始设计适合患者个人的定制女仆的人造颞下颌关节。少