Development of an artificial temporomandibular joint disc replacement
Date
2023
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Abstract
The temporomandibular joint (TMJ) is a complex bilateral ginglymoarthroidal joint containing a fibrocartilaginous disc and is essential for chewing, speaking, and swallowing. Due to the high loading frequency, small imbalances in joint homeostasis can overcome the natural capacity for adaptation and lead to a cascade of degenerative changes. For progressive TMJ disorders, resection of the TMJ disc is the leading treatment, but disc resection inherently increases stress and friction on the articular cartilage surfaces, leading to a progression to total joint replacement in 11.7% of patients. The current methods of treatment for disorders of the TMJ musculoskeletal complex are predominantly palliative and do not reliably address disorders of arthrogenous origin. Unfortunately, no synthetic TMJ disc replacements currently exist due to profound implant failures in earlier attempts. Introduction of a robust artificial TMJ disc replacement after resection will prevent further joint degradation and improve patient outcomes. Rigorous preclinical evaluation of artificial TMJ disc replacement strategies must be conducted to support future translation to humans. Therefore, the following aims are proposed: (1) Characterize the biomechanical behavior of the ovine temporomandibular joint soft tissues, (2) identify and evaluate a material candidate for a temporomandibular joint disc replacement, (3) develop in silico and in vitro methods for evaluating design candidates for artificial TMJ disc replacement, and (4) implement a temporomandibular joint disc replacement strategy in an ovine model.
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Embargo expires: 08/28/2025.
Subject
finite element
polyvinyl alcohol hydrogel
artificial disc replacement
temporomandibular joint disc
mechanical characterization