Niedzielska Iwona, Bąk Michał, Niedzielski Damian, Okła Hubert, Gabor Jadwiga, Stanula Arkadiusz, Paluch Jarosław, Swinarew Andrzej Szymon
Department of Cranio-Maxillo-Facial Surgery, Medical University of Silesia in Katowice, ul. Francuska 20-24, 40-027 Katowice, Poland.
Faculty of Science and Technology, University of Silesia in Katowice, 75 Pułku Piechoty 1A, 41-500 Chorzów, Poland.
J Funct Biomater. 2021 Jan 26;12(1):7. doi: 10.3390/jfb12010007.
The aim of this study was to quantitatively evaluate alloplastic Temporomandibular Joint (TMJ) Prostheses against other treatment modalities regarding the jaw kinematics. Six patients with Temporomandibular Joint Prostheses, four with mandibular ramus Patient-Specific Implant (PSI) with condylar head preservation, and four after mandibular condylectomy were evaluated by the means of axiography (Cadiax Compact 2), which is the noninvasive three-dimensional study of condylar movements. The patients were also evaluated clinically for the mandibular movements. The study revealed that the significant movement limitations occurred bilaterally in patients fitted with TMJ prosthesis. For the protrusion movement, the vector length of the movement (L) for the TMJ prosthesis was 0.31 vs. 3.01 mm for the PSI (Kruskal-Wallis chi-squared = 9.1667, df = 2, -value = 0.01022, post hoc Dunn -value = 0.015) and for the laterotrusion to the operated side, the length of the vector (L) was 0.66 vs. 3.35 mm, respectively. Statistically significant differences between groups were most frequent for the laterotrusion to the unoperated side. The study shows that a further development on TMJ Prostheses geometry and materials is needed.
本研究的目的是就颌运动学方面，对异质人工颞下颌关节（TMJ）假体与其他治疗方式进行定量评估。通过轴面描记法（Cadiax Compact 2）对6例植入TMJ假体的患者、4例采用保留髁突头部的下颌升支患者特异性植入物（PSI）的患者以及4例接受下颌髁突切除术的患者进行了评估，轴面描记法是一种对髁突运动进行的非侵入性三维研究。还对患者的下颌运动进行了临床评估。研究发现，植入TMJ假体的患者双侧出现了明显的运动受限。对于前伸运动，TMJ假体的运动矢量长度（L）为0.31 mm，而PSI的为3.01 mm（Kruskal-Wallis卡方检验=9.1667，自由度=2，P值=0.01022，事后邓恩检验P值=0.015）；对于向手术侧的侧方运动，矢量长度（L）分别为0.66 mm和3.35 mm。组间在向未手术侧的侧方运动方面差异最常具有统计学意义。该研究表明，TMJ假体的几何形状和材料需要进一步改进。
