Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, P.O. Box 30.001, 9700, RB Groningen, The Netherlands.
J Craniomaxillofac Surg. 2018 May;46(5):779-784. doi: 10.1016/j.jcms.2018.03.004. Epub 2018 Mar 14.
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.
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.
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.
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.
患有颞下颌关节（TMJ）骨关节炎、强直（例如创伤后或肿瘤）的患者可能会出现张口严重受限、疼痛或下颌其他动态受限等症状。为缓解这些症状，可以考虑使用全关节假体，例如 Groningen TMJ 假体。该假体设计为降低旋转中心的标准假体，以提高平移和开口能力。本研究旨在改进假体设计，并制定定制 Groningen TMJ 假体的工作流程，以使其更准确和可预测。
定制 Groningen TMJ 假体的髁突和下颌部分。对五具人体尸体进行了一系列手术，并使用定制的切割和钻孔导向器放置双侧 TMJ 假体。根据术后 CT 数据评估放置准确性。
共放置和分析了 N=10 个假体。从计划到实际位置的平均欧几里得距离偏差为 0.81 毫米（标准差 0.21）。所有假体均按照常规手术入路放置，与骨结构的对齐非常好。
新开发的定制 Groningen TMJ 假体可以非常精确地放置，是改善 TMJ 全关节置换手术的第一步。
