Development of artificial tempolomandibular joint

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When the deformation and the destruction on each joint of the body occurs due to aging or various diseases, the total replacement of the joint may be adopt for morphological and functional reconstruction. However, an alloplastic temporo-mandibular joint (TMJ) components have not developed in Japan yet, and no effedtive treatment exists for the functional disorder originated in a structural destruction of TMJ.In this study, we measured the forms of human TMJs and analyzed them dynamically under mastication to develop a alloplastic TMJ for Japanese patient. Furthermore, we manufactured the prototype and applied it clinically to examine the masticatory efficiency, the movement and the frictional wear of TMJ.Then, the alloplastic TMJ components was accomplished improving the prototypes.Three-dimensional (3D) morphometory of TMJs were performed with 3D-computed tomography (CT) or dry skulls from autopsy using the high accuracy 3D measuring apparatus. The stress on the TMJ under mastication was calculated from the surface forms of condyle and fossa obtained from measurements. Then, proper bio-materials were selected, an appropriate shape of alloplastic TMJ was designed and manufactured for trial. For clinical applications, the rheumatoid arthritis with destruction of TMJ which had masticatory disorder and obstructive sleep apnea syndrome, and the congenital hypoplasia of TMJs were adopted. The masticatory function was investigated by food trituration test, and the wear degree and movement of the alloplastic TMJ components were checked up by cineradiography and ultrasonography after operation. From these data, we designed it again and now are carrying out the material fatigue test. After that we will apply it again clinically.