Lateral pterygoid muscle enthesis reconstruction in total temporomandibular joint replacement: An animal experiment with radiological correlation

Meurechy, Nikolas De; Verwilghen, Denis; Brucker, Yannick De; Thielen, Bert Van; Mommaerts, Maurice Y.

doi:10.1016/j.jcms.2021.01.029

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…A multi‐layer closure was then performed, after which a compressive bandage was applied. A more detailed description of the surgery protocol can be found in one of our earlier published papers 24 …”

Section: Methodsmentioning

confidence: 99%

“…A more detailed description of the surgery protocol can be found in one of our earlier published papers. 24 …”

Section: Methodsmentioning

confidence: 99%

“…After the developing of a novel patient‐specific additively manufactured (AM, also referred to as 3D‐printed) titanium (Ti) alloy TMJ replacement system by CADskills BV, which aims to restore laterotrusive movement through reinsertion and integration of the lateral pterygoid muscle (LPM), a sheep model animal experiment was designed to further investigation. 2 , 20 , 21 , 22 , 23 Whereas the proper implant integration and LPM insertion was previously evaluated, 24 this paper aims to evaluate the in vivo wear rate in the condylar and fossa components. Furthermore, the difference in wear between the polished condylar head, coated with a HadSat® diamond‐like carbon (H‐DLC) layer, was investigated and compared to that of the non‐coated condylar head.…”

Section: Introductionmentioning

confidence: 99%

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Surface wear in a custom manufactured temporomandibular joint prosthesis

et al. 2022

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The wear of a novel temporomandibular joint (TMJ) prosthesis was evaluated in an animal model. The prosthesis consisted of an additively manufactured titanium alloy (Ti6Al4V) mandibular condyle and glenoid fossa created through selective laser melting, with a machined vitamin E‐enriched ultra‐high molecular weight polyethylene (UHMWPE) surface attached to the fossa. Thirteen TMJ prosthesis were implanted in sheep, six of which had condylar heads coated with HadSat® diamond‐like carbon (H‐DLC). Euthanasia took place after 288 days, equaling 22 years of human mastication. Linear and volumetric wear analysis of the fossa was performed by optical scanning. The condylar head surfaces were assessed by scanning electron and confocal laser microscopy. The average linear UHMWPE wear, when combined with the coated condyle, was 0.67 ± 0.28 mm (range: 0.34–1.15 mm), not significantly differing (p = .3765, t‐test) from the non‐coated combination average (0.88 ± 0.41 mm; range: 0.28–1.48 mm). The respective mean volumetric wear volumes were 25.29 ± 11.43 mm3 and 45.85 ± 22.01 mm3, not significantly differing (p = .1448, t‐test). Analysis of the coated condylar surface produced a mean Ra of 0.12 ± 0.04 μm and Sa of 0.69 ± 0.07 μm. The non‐coated condylar surface measured a mean Ra of 0.28 ± 0.17 μm and Sa of 2.40 ± 2.08 μm. Both Sa (p = .0083, Mann–Whitney U test) and Ra (p = .0182, Mann–Whitney U test), differed significantly. The prosthesis exhibits acceptable wear resistance and addition of the H‐DLC‐coating significantly improved long‐term condylar surface smoothness.

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Section: Methodsmentioning

confidence: 99%

“…A more detailed description of the surgery protocol can be found in one of our earlier published papers. 24 …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surface wear in a custom manufactured temporomandibular joint prosthesis

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“…After thoroughly evaluating the proposed implants in sheep experiments, 18,19 eleven patients (2 men, 9 women; mean age at surgery of 49 years, 1 months) received all together 16 customized total TMJ Parametro prostheses. The surgery was performed by one surgeon in the same hospital.…”

Section: Patients and Methodologymentioning

confidence: 99%

“…In a sheep model of TMJ replacement, postoperative function suggested that filling the scaffold with autologous bone chips was sufficient. 18 The addition of calcium phosphate may hinder reattachment, even if more bone will be formed within the pores, 65 and the addition of bone marrow-derived mesenchymal stem cells has not been clinically proven to enhance bony fusion. 66,67 Even though an increase in movement capabilities can be seen by using this method, longstanding limitations of lateral movements cannot be undone by lateral pterygoid reattachment.…”

Section: Heterotopic Ossificationmentioning

confidence: 99%

Evolutionary Steps in the Development of a Patient-specific Temporomandibular Joint Prosthesis

Huys

Braem

Meurechy

et al. 2022

Craniomaxillofacial Research & Innovation

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Study Design Descriptive study (/review containing supporting case studies). Objective The temporomandibular joint has some distinctive features that were not taken into account during the initial development of temporomandibular joint prostheses, such as laterotrusive movements that are necessary for the proper grinding of food as well as synchronous and congruent movements made in conjunction with the healthy, contralateral joint. The aim of this article is to describe the development of a novel type of TMJ prosthesis that optimizes temporomandibular joint replacement. Methods The development was initiated by using contemporary technologies like computer-aided design customization, additive manufacturing, and surface treatments. Biocompatibility, proper fixation, and wear resistance, being prerequisites for the longevity of prostheses, were investigated next. Individual variables (condylar path, condylar axis angle, Bennet shift) were introduced as the main basis for physiological movements with the restoration of all functions. Early post-operative results ranging from 1 month to 4.5 years (11 patients, average follow-up period was 23.3 months) were assessed. Results The experience with 16 individualized total joint replacements in 11 patients is presented. The 3-year follow-up results of two-patient detailed studies are discussed, which show evidence of the promising restoration of all mandibular movements, when preoperatively present. Conclusions By incorporating various innovative and novel features (scaffold for re-attachment of lateral pterygoid, patient-specific functional parametrization, saddle-like design for retention, …) into a novel TMJ prosthesis concept, a major advance in function-reconstructive temporomandibular joint replacement was achieved. Early in vivo results (1 year after surgery) showed promising outcomes, involving both high increases in mandibular movements and decreases in pain scores.

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