Patient specific individual computational mechanics for diagnosis and treatment planning of temporomandibular joint disorder

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Individual geometry of temporomandibular joint(TMJ) was retrieved from MR images and was used for the finite element modeling of individual patient. The condyle trajectory was determined by referring to its position at different mouth opening positions, and used for the stress analysis of soft tissue components of temporomandibular joints. The typical stress conditions in the TMJ disc and the retrodiscal connective tissue were investigated for normal TMJs and for anterior-disc-displaced TMJs. The sensitivity analysis with condyle position demonstrated that the perturbation in inferior direction at the fully-mouth-open position and the perturbation in inferior direction with small rotation at the mouth-closed position were effective for the disc reduction during the mouth opening motion of anterior-disc-displaced TMJs. The individual finite element model was extended with the frame structures for the mandible bone connected to the finite elements of condyle and for the temporal bone behind the elements of glenoid fossa. These frames were interconnected by muscles of mastication under the contacting conditions at anterior/posterior tooth, and the extended model enabled us to examine the stress condition of soft tissue components of viscoelasticity under the clenching. The parameter studies suggested us that the comparison of the results of individual finite element analysis with the results of medical imaging analysis has the potential to estimate the elastic characteristics of the soft tissue components towards the diagnosis and to probe the treatment condition of the adjustment of relative position of bony components leading the condyle trajectory for the reasonable stress condition of the soft tissue components.