For patients who suffer from severe dysfunction of the temporomandibular joint (TMJ), a total joint replacement (TJR) in the form of a prosthesis may be indicated. The position of the centre of rotation in TJRs is crucial for good postoperative oral function; however, it is not determined patient-specifically (PS) in any current TMJ-TJR. The aim of this current study was to develop a 4D-workflow to ascertain the PS mean axis of rotation, or fixed hinge, that mimics the patient’s specific physiological mouth opening. Twenty healthy adult patients were asked to volunteer for a 4D-scanning procedure. From these 4D-scanning recordings of mouth opening exercises, patient-specific centres of rotation and axes of rotation were determined using our JawAnalyser tool. The mean CR location was positioned 28 [mm] inferiorly and 5.5 [mm] posteriorly to the centre of condyle (CoC). The 95% confidence interval ranged from 22.9 to 33.7 [mm] inferior and 3.1 to 7.8 [mm] posterior to the CoC. This study succeeded in developing an accurate 4D-workflow to determine a PS mean axis of rotation that mimics the patient’s specific physiological mouth opening. Furthermore, a change in concept is necessary for all commercially available TMJ-TJR prostheses in order to comply with the PS CRs calculated by our study. In the meantime, it seems wise to stick to placing the CR 15 [mm] inferiorly to the CoC, or even beyond, towards 28 [mm] if the patient’s anatomy allows this.
Four-Dimensional Determination of the Patient-Specific Centre of Rotation for Total Temporomandibular Joint Replacements:Following the Groningen Principle
2022-09-01
Merema , B B J , Witjes , M J H , Van Bakelen , N B , Kraeima , J & Spijkervet , F K L 2022 , ' Four-Dimensional Determination of the Patient-Specific Centre of Rotation for Total Temporomandibular Joint Replacements : Following the Groningen Principle ' , Journal of personalized medicine , vol. 12 , no. 9 , 1439 . https://doi.org/10.3390/jpm12091439
Aufsatz (Zeitschrift)
Elektronische Ressource
Englisch
3D-VSP , 4D , custom , jaw , kinematic , mandible , motion analysis , patient-specific , prosthesis , TJR , TMJ , virtual surgical planning
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