van Loon J P, de Bont G M, Boering G
Department of Oral and Maxillofacial Surgery, University Hospital, Groningen, The Netherlands.
J Oral Maxillofac Surg. 1995 Sep;53(9):984-96; discussion 996-7. doi: 10.1016/0278-2391(95)90110-8.
This article describes the useful elements of applied temporomandibular joint (TMJ) prostheses and discusses the factors necessary to be addressed in an appropriate TMJ prostheses design.
Information about TMJ prostheses was gathered by a literature search. Only designs with the primary intention of true joint replacement were selected. The designs were divided in fossa-eminence, condylar, and total joint replacements, which are reviewed separately.
A fossa-eminence prosthesis can be fixed by a metal plate screwed to the root of the zygomatic arch. A condylar prosthesis can be fixed by a metal plate screwed to the mandibular ramus and fitted by bending the plate or using different sizes. All reviewed designs resulted in a loss of translational movements of the mandible, especially in an anterior direction. Although the recent designs use the same materials as are used in hip and knee joint prostheses, the wear properties of the existing TMJ prostheses are still unknown.
A future prosthesis must imitate the anterior movement of the mandible when the mouth is opened and also allow some mediolateral movement. The fitting to the skull is still a major problem, as is the combination of the required motions and low wear rates. To confirm good clinical performance of a new TMJ prosthesis, long-term follow-up studies are necessary.
本文描述了应用颞下颌关节（TMJ）假体的有用元件，并讨论了在适当的TMJ假体设计中需要考虑的因素。
通过文献检索收集有关TMJ假体的信息。仅选择主要用于真正关节置换的设计。这些设计分为窝-隆突、髁突和全关节置换，分别进行综述。
窝-隆突假体可通过拧在颧弓根部的金属板固定。髁突假体可通过拧在下颌支上的金属板固定，并通过弯曲金属板或使用不同尺寸进行适配。所有综述的设计都导致下颌平移运动丧失，尤其是向前方向的运动。尽管最近的设计使用了与髋关节和膝关节假体相同的材料，但现有TMJ假体的磨损特性仍然未知。
未来的假体必须模仿张口时下颌的向前运动，并且还应允许一些内外侧运动。与颅骨的适配仍然是一个主要问题，所需运动与低磨损率的结合也是如此。为了确认新型TMJ假体的良好临床性能，长期随访研究是必要的。
