Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions

Abstract Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies hav...

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Autores principales:	Manuel Pinheiro, Robin Willaert, Afaq Khan, Anouar Krairi, Wim Van Paepegem
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8260bc5ba3dc45e08542af4f613136b5
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spelling	oai:doaj.org-article:8260bc5ba3dc45e08542af4f613136b52021-12-02T18:34:20ZBiomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions10.1038/s41598-021-93564-32045-2322https://doaj.org/article/8260bc5ba3dc45e08542af4f613136b52021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93564-3https://doaj.org/toc/2045-2322Abstract Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.Manuel PinheiroRobin WillaertAfaq KhanAnouar KrairiWim Van PaepegemNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Manuel Pinheiro Robin Willaert Afaq Khan Anouar Krairi Wim Van Paepegem Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
description	Abstract Temporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.
format	article
author	Manuel Pinheiro Robin Willaert Afaq Khan Anouar Krairi Wim Van Paepegem
author_facet	Manuel Pinheiro Robin Willaert Afaq Khan Anouar Krairi Wim Van Paepegem
author_sort	Manuel Pinheiro
title	Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
title_short	Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
title_full	Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
title_fullStr	Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
title_full_unstemmed	Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
title_sort	biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8260bc5ba3dc45e08542af4f613136b5
work_keys_str_mv	AT manuelpinheiro biomechanicalevaluationofthehumanmandibleaftertemporomandibularjointreplacementunderdifferentbitingconditions AT robinwillaert biomechanicalevaluationofthehumanmandibleaftertemporomandibularjointreplacementunderdifferentbitingconditions AT afaqkhan biomechanicalevaluationofthehumanmandibleaftertemporomandibularjointreplacementunderdifferentbitingconditions AT anouarkrairi biomechanicalevaluationofthehumanmandibleaftertemporomandibularjointreplacementunderdifferentbitingconditions AT wimvanpaepegem biomechanicalevaluationofthehumanmandibleaftertemporomandibularjointreplacementunderdifferentbitingconditions
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Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions

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