The Experts below are selected from a list of 150 Experts worldwide ranked by ideXlab platform
J P Van Loon - One of the best experts on this subject based on the ideXlab platform.
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groningen Temporomandibular Joint Prosthesis development and first clinical application
International Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Frederik Spijkervet, Gijsbertus Jacob VerkerkeAbstract:Patients with a severely degenerated Temporomandibular Joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ Prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre of rotation, unrestricted mandibular movements by a double articulation, correct fit to the skull by a self-adjusting skull part consisting of two connected parts, and stable fixation by bone screws that are rigidly connected to the Prosthesis parts. The Prosthesis consists of a titanium skull part with ceramic inlay, a titanium mandibular part with a ceramic spherical head, and an intervening polyethylene disc. Titanium-alloy bone screws are used for fixation. All parts are available in a number of different shapes. In vitro laboratory and in vivo animal tests showed a low wear rate, the possibility of a close fit to the skull, a stable fixation, sufficient mechanical strength, appropriate choice of materials and proper functioning. Thereafter the step to first patient application was made. First patient application was carried out without adverse events. In conclusion, the presented TMJ Prosthesis passed the pre-clinical tests and has progressed to clinical application. The fit to the skull, the expected lifetime of the device and the reliability of the implantation procedure require further evaluation in well-designed clinical trials.
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fitting a Temporomandibular Joint Prosthesis to the skull
Journal of Oral Rehabilitation, 2000Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Gijsbertus Jacob VerkerkeAbstract:Fitting a Temporomandibular Joint (TMJ) Prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was to test whether it is possible to achieve a close fit to the skull with this design, with a maximum of 10 different parts. The articular eminence was fitted with a gully-shaped fitting member, which was rotationally connected to a basic part that fitted to the lateral side of the TMJ. The relevant dimensions of 20 dry skulls were measured and the results were used to derive the optimal dimensions of the Prosthesis parts. Prototypes were subsequently fabricated. The fit of the prototypes was tested by measuring the maximum gap between fitting member and skull. All skulls could be fit with a set of four different basic parts and three different fitting members. The average maximum gap between fitting member and skull was 0-20 mm (range 0.11-0.43 mm). It was concluded that a close fit to the skull can be achieved with two connected stock parts and with a total number of seven parts.
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a short term study in sheep with the groningen Temporomandibular Joint Prosthesis
International Journal of Oral and Maxillofacial Surgery, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Frederik Spijkervet, Rsb LiemAbstract:Abstract As part of the pre-clinical testing process of a newly developed Temporomandibular Joint (TMJ) Prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ Prosthesis. The Prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8–16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2–10 weeks. One sheep was excluded because no correct position of the Prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ Prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing.
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design and wear testing of a Temporomandibular Joint Prosthesis articulation
Journal of Dental Research, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, M P De Vries, L G M De BontAbstract:As part of the development of a total Temporomandibular Joint Prosthesis, a Prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial side, which slides along the opposing skull part. The aim of this study was to determine the in vitro wear rate of the articulation, and to predict the in vivo wear rate from the results. Based on a disc thickness of 5 mm and a ball diameter of 8 mm, the stresses within the disc were calculated by means of a finite element computer model. The wear rate of the ball-disc articulation was determined by in vitro wear tests, with a stainless-steel ball rotating against a UHMWPE disc in a serum-based lubricant. Eight discs were tested for seven million cycles each. The in vitro wear rate of the disc-skull part articulation was calculated from the test results of the ball-disc articulation. The maximum Von Mises' stress ...
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wear testing of a Temporomandibular Joint Prosthesis uhmwpe and ptfe against a metal ball in water and in serum
Biomaterials, 1999Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Rsb LiemAbstract:For a Temporomandibular Joint Prosthesis, an estimation of the wear rate was needed, prior to patient application. Therefore, we determined the in vitro wear rate of the ball-socket articulation of this Prosthesis, consisting of a metal head and an ultra-high molecular weight polyethylene (UHMWPE) cup. The basic testing configuration consisted of one 8-mm diameter stainless-steel ball, rotating between two conforming cups with a minimum thickness of 5 mm. For validation of the testing apparatus, two cup materials, in two lubricants, were tested. Both cup materials, UHMWPE and polytetrafluoroethylene (PTFE) were tested in deionized water, as well as in a serum-based solution. For UHMWPE in serum, eight samples were tested, for the other combinations four samples. For UHMWPE, the tests ran for 7 million cycles, for PTFE between 0.8 and 1.7 million cycles. For UHMWPE, the wear rate was 0.006 and 0.47 (mm(3)/10(6) cycles), in water and in serum, respectively. For PTFE, the wear rate was 2.8 and 47 (mm(3)/10(6) cycles), in water and in serum, respectively. For reason that testing in serum simulates the in vivo situation best, it was concluded that the wear rate of the TMJ Prosthesis articulation is 0.47 (mm(3)/10(6) cycles), which is considered acceptable. (C) 1999 Elsevier Science Ltd. All rights reserved.
L G M De Bont - One of the best experts on this subject based on the ideXlab platform.
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groningen Temporomandibular Joint Prosthesis development and first clinical application
International Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Frederik Spijkervet, Gijsbertus Jacob VerkerkeAbstract:Patients with a severely degenerated Temporomandibular Joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ Prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre of rotation, unrestricted mandibular movements by a double articulation, correct fit to the skull by a self-adjusting skull part consisting of two connected parts, and stable fixation by bone screws that are rigidly connected to the Prosthesis parts. The Prosthesis consists of a titanium skull part with ceramic inlay, a titanium mandibular part with a ceramic spherical head, and an intervening polyethylene disc. Titanium-alloy bone screws are used for fixation. All parts are available in a number of different shapes. In vitro laboratory and in vivo animal tests showed a low wear rate, the possibility of a close fit to the skull, a stable fixation, sufficient mechanical strength, appropriate choice of materials and proper functioning. Thereafter the step to first patient application was made. First patient application was carried out without adverse events. In conclusion, the presented TMJ Prosthesis passed the pre-clinical tests and has progressed to clinical application. The fit to the skull, the expected lifetime of the device and the reliability of the implantation procedure require further evaluation in well-designed clinical trials.
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fitting a Temporomandibular Joint Prosthesis to the skull
Journal of Oral Rehabilitation, 2000Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Gijsbertus Jacob VerkerkeAbstract:Fitting a Temporomandibular Joint (TMJ) Prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was to test whether it is possible to achieve a close fit to the skull with this design, with a maximum of 10 different parts. The articular eminence was fitted with a gully-shaped fitting member, which was rotationally connected to a basic part that fitted to the lateral side of the TMJ. The relevant dimensions of 20 dry skulls were measured and the results were used to derive the optimal dimensions of the Prosthesis parts. Prototypes were subsequently fabricated. The fit of the prototypes was tested by measuring the maximum gap between fitting member and skull. All skulls could be fit with a set of four different basic parts and three different fitting members. The average maximum gap between fitting member and skull was 0-20 mm (range 0.11-0.43 mm). It was concluded that a close fit to the skull can be achieved with two connected stock parts and with a total number of seven parts.
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a short term study in sheep with the groningen Temporomandibular Joint Prosthesis
International Journal of Oral and Maxillofacial Surgery, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Frederik Spijkervet, Rsb LiemAbstract:Abstract As part of the pre-clinical testing process of a newly developed Temporomandibular Joint (TMJ) Prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ Prosthesis. The Prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8–16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2–10 weeks. One sheep was excluded because no correct position of the Prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ Prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing.
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design and wear testing of a Temporomandibular Joint Prosthesis articulation
Journal of Dental Research, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, M P De Vries, L G M De BontAbstract:As part of the development of a total Temporomandibular Joint Prosthesis, a Prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial side, which slides along the opposing skull part. The aim of this study was to determine the in vitro wear rate of the articulation, and to predict the in vivo wear rate from the results. Based on a disc thickness of 5 mm and a ball diameter of 8 mm, the stresses within the disc were calculated by means of a finite element computer model. The wear rate of the ball-disc articulation was determined by in vitro wear tests, with a stainless-steel ball rotating against a UHMWPE disc in a serum-based lubricant. Eight discs were tested for seven million cycles each. The in vitro wear rate of the disc-skull part articulation was calculated from the test results of the ball-disc articulation. The maximum Von Mises' stress ...
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wear testing of a Temporomandibular Joint Prosthesis uhmwpe and ptfe against a metal ball in water and in serum
Biomaterials, 1999Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Rsb LiemAbstract:For a Temporomandibular Joint Prosthesis, an estimation of the wear rate was needed, prior to patient application. Therefore, we determined the in vitro wear rate of the ball-socket articulation of this Prosthesis, consisting of a metal head and an ultra-high molecular weight polyethylene (UHMWPE) cup. The basic testing configuration consisted of one 8-mm diameter stainless-steel ball, rotating between two conforming cups with a minimum thickness of 5 mm. For validation of the testing apparatus, two cup materials, in two lubricants, were tested. Both cup materials, UHMWPE and polytetrafluoroethylene (PTFE) were tested in deionized water, as well as in a serum-based solution. For UHMWPE in serum, eight samples were tested, for the other combinations four samples. For UHMWPE, the tests ran for 7 million cycles, for PTFE between 0.8 and 1.7 million cycles. For UHMWPE, the wear rate was 0.006 and 0.47 (mm(3)/10(6) cycles), in water and in serum, respectively. For PTFE, the wear rate was 2.8 and 47 (mm(3)/10(6) cycles), in water and in serum, respectively. For reason that testing in serum simulates the in vivo situation best, it was concluded that the wear rate of the TMJ Prosthesis articulation is 0.47 (mm(3)/10(6) cycles), which is considered acceptable. (C) 1999 Elsevier Science Ltd. All rights reserved.
Gijsbertus Jacob Verkerke - One of the best experts on this subject based on the ideXlab platform.
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groningen Temporomandibular Joint Prosthesis development and first clinical application
International Journal of Oral and Maxillofacial Surgery, 2002Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Frederik Spijkervet, Gijsbertus Jacob VerkerkeAbstract:Patients with a severely degenerated Temporomandibular Joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ Prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre of rotation, unrestricted mandibular movements by a double articulation, correct fit to the skull by a self-adjusting skull part consisting of two connected parts, and stable fixation by bone screws that are rigidly connected to the Prosthesis parts. The Prosthesis consists of a titanium skull part with ceramic inlay, a titanium mandibular part with a ceramic spherical head, and an intervening polyethylene disc. Titanium-alloy bone screws are used for fixation. All parts are available in a number of different shapes. In vitro laboratory and in vivo animal tests showed a low wear rate, the possibility of a close fit to the skull, a stable fixation, sufficient mechanical strength, appropriate choice of materials and proper functioning. Thereafter the step to first patient application was made. First patient application was carried out without adverse events. In conclusion, the presented TMJ Prosthesis passed the pre-clinical tests and has progressed to clinical application. The fit to the skull, the expected lifetime of the device and the reliability of the implantation procedure require further evaluation in well-designed clinical trials.
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fitting a Temporomandibular Joint Prosthesis to the skull
Journal of Oral Rehabilitation, 2000Co-Authors: J P Van Loon, L G M De Bont, B Stegenga, Gijsbertus Jacob VerkerkeAbstract:Fitting a Temporomandibular Joint (TMJ) Prosthesis to the skull by using stock prostheses seems to be an appropriate method. However, fitting the skull with one stock part requires many differently shaped parts. Therefore, we fitted the skull with two connected stock parts. The aim of the study was to test whether it is possible to achieve a close fit to the skull with this design, with a maximum of 10 different parts. The articular eminence was fitted with a gully-shaped fitting member, which was rotationally connected to a basic part that fitted to the lateral side of the TMJ. The relevant dimensions of 20 dry skulls were measured and the results were used to derive the optimal dimensions of the Prosthesis parts. Prototypes were subsequently fabricated. The fit of the prototypes was tested by measuring the maximum gap between fitting member and skull. All skulls could be fit with a set of four different basic parts and three different fitting members. The average maximum gap between fitting member and skull was 0-20 mm (range 0.11-0.43 mm). It was concluded that a close fit to the skull can be achieved with two connected stock parts and with a total number of seven parts.
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a short term study in sheep with the groningen Temporomandibular Joint Prosthesis
International Journal of Oral and Maxillofacial Surgery, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Frederik Spijkervet, Rsb LiemAbstract:Abstract As part of the pre-clinical testing process of a newly developed Temporomandibular Joint (TMJ) Prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ Prosthesis. The Prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8–16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2–10 weeks. One sheep was excluded because no correct position of the Prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ Prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing.
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design and wear testing of a Temporomandibular Joint Prosthesis articulation
Journal of Dental Research, 2000Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, M P De Vries, L G M De BontAbstract:As part of the development of a total Temporomandibular Joint Prosthesis, a Prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial side, which slides along the opposing skull part. The aim of this study was to determine the in vitro wear rate of the articulation, and to predict the in vivo wear rate from the results. Based on a disc thickness of 5 mm and a ball diameter of 8 mm, the stresses within the disc were calculated by means of a finite element computer model. The wear rate of the ball-disc articulation was determined by in vitro wear tests, with a stainless-steel ball rotating against a UHMWPE disc in a serum-based lubricant. Eight discs were tested for seven million cycles each. The in vitro wear rate of the disc-skull part articulation was calculated from the test results of the ball-disc articulation. The maximum Von Mises' stress ...
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wear testing of a Temporomandibular Joint Prosthesis uhmwpe and ptfe against a metal ball in water and in serum
Biomaterials, 1999Co-Authors: J P Van Loon, Gijsbertus Jacob Verkerke, L G M De Bont, Rsb LiemAbstract:For a Temporomandibular Joint Prosthesis, an estimation of the wear rate was needed, prior to patient application. Therefore, we determined the in vitro wear rate of the ball-socket articulation of this Prosthesis, consisting of a metal head and an ultra-high molecular weight polyethylene (UHMWPE) cup. The basic testing configuration consisted of one 8-mm diameter stainless-steel ball, rotating between two conforming cups with a minimum thickness of 5 mm. For validation of the testing apparatus, two cup materials, in two lubricants, were tested. Both cup materials, UHMWPE and polytetrafluoroethylene (PTFE) were tested in deionized water, as well as in a serum-based solution. For UHMWPE in serum, eight samples were tested, for the other combinations four samples. For UHMWPE, the tests ran for 7 million cycles, for PTFE between 0.8 and 1.7 million cycles. For UHMWPE, the wear rate was 0.006 and 0.47 (mm(3)/10(6) cycles), in water and in serum, respectively. For PTFE, the wear rate was 2.8 and 47 (mm(3)/10(6) cycles), in water and in serum, respectively. For reason that testing in serum simulates the in vivo situation best, it was concluded that the wear rate of the TMJ Prosthesis articulation is 0.47 (mm(3)/10(6) cycles), which is considered acceptable. (C) 1999 Elsevier Science Ltd. All rights reserved.
Jisi Zheng - One of the best experts on this subject based on the ideXlab platform.
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endoscopically assisted fixation of the custom made total Temporomandibular Joint Prosthesis in tmj yang s system through a modified preauricular approach
International Journal of Oral and Maxillofacial Surgery, 2020Co-Authors: Jisi Zheng, A. Ahmed, M.j. Chen, S.y. Zhang, Chongqing YangAbstract:Abstract This article describes the experience with the endoscopically assisted fixation of the customized total Temporomandibular Joint (TMJ) Prosthesis in TMJ Yang’s system only through a modified preauricular approach. Twenty patients (23 Joints) treated with the custom-made total TMJ Prosthesis were retrospectively recruited. An endoscopically assisted technique was used through a modified preauricular approach to fix the mandibular component for all these patients. These reconstructions were evaluated by surgical records, clinical examinations, and radiographic observations. All patients had successful fixation of the Prosthesis. No patient had permanent weakness of the facial nerve and malocclusion or any other severe complications. The mean operative time was 111 min per Joint (range, 85–133 min). The average surgical bleeding was 195 ml per side. The mean follow-up period was 16.2 months (range, 5–32 months). The mean scores were 8.3 for surgical satisfaction and 9.2 for scar healing evaluation. All patients experienced positive clinical outcomes, with a mean 75.2% reduction in pain and 53.7% increase in mouth opening with significant differences ( P
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Endoscopically assisted fixation of the custom-made total Temporomandibular Joint Prosthesis in TMJ Yang’s system through a modified preauricular approach
International Journal of Oral and Maxillofacial Surgery, 2019Co-Authors: Jisi Zheng, A. Ahmed, M.j. Chen, S.y. Zhang, Chongqing YangAbstract:Abstract This article describes the experience with the endoscopically assisted fixation of the customized total Temporomandibular Joint (TMJ) Prosthesis in TMJ Yang’s system only through a modified preauricular approach. Twenty patients (23 Joints) treated with the custom-made total TMJ Prosthesis were retrospectively recruited. An endoscopically assisted technique was used through a modified preauricular approach to fix the mandibular component for all these patients. These reconstructions were evaluated by surgical records, clinical examinations, and radiographic observations. All patients had successful fixation of the Prosthesis. No patient had permanent weakness of the facial nerve and malocclusion or any other severe complications. The mean operative time was 111 min per Joint (range, 85–133 min). The average surgical bleeding was 195 ml per side. The mean follow-up period was 16.2 months (range, 5–32 months). The mean scores were 8.3 for surgical satisfaction and 9.2 for scar healing evaluation. All patients experienced positive clinical outcomes, with a mean 75.2% reduction in pain and 53.7% increase in mouth opening with significant differences ( P
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an innovative total Temporomandibular Joint Prosthesis with customized design and 3d printing additive fabrication a prospective clinical study
Journal of Translational Medicine, 2019Co-Authors: Jisi Zheng, Xuzhuo Chen, Wenbo Jiang, Shanyong Zhang, Minjie Chen, Chi YangAbstract:Total Temporomandibular Joint (TMJ) Prosthesis is an effective and reliable method of Joint reconstruction. However, there is still an urgent need to design a new TMJ Prosthesis because of no commercially available TMJ Prosthesis appropriate for the clinical application on the Chinese population. This study was introduced to prospectively confirm the safety and effectiveness of a new TMJ Prosthesis with customized design and 3D printing additive fabrication in clinical application. Patients with unilateral end-stage TMJ osteoarthrosis were recruited in this study from Nov 2016 to Mar 2017. Computed tomography scans for all patients were obtained and transformed into three-dimensional (3D) reconstruction models. The customized TMJ Prosthesis consisted of three components including the fossa, condylar head, and mandibular handle units, which were designed based on the anatomy of the TMJ and were fabricated using the 3D printing technology. The prominent characters of the Prosthesis were the customized design of the fossa component with a single ultra-high-molecular-weight polyethylene and the connection mechanism between the condylar head (Co–Cr–Mo alloy) and mandibular handle components (Ti6Al4 V alloy). The clinical follow-up, radiographic evaluation and laboratory indices were all done to analyze the Prosthesis’ outcomes in the clinical application. 12 consecutive patients were included in the study. There were no complications (infection of the surgical wound, damage of liver and kidney, displacement, breakage, or loosening of the Prosthesis) found after surgery. Pain, diet, mandibular function, and maximal interincisal opening showed significant improvements after surgery. But the lateral movement was limited to the non-operated side and the mandible deviated towards the operated side on opening mouth following surgery. The presented TMJ Prosthesis is considered an innovative product in TMJ Yang’s system, which is unique compared to other prostheses for the special design and 3D printing additive manufacture. Moreover, the Prosthesis is very safe and efficient for clinical use. Trial registration Prospective reports on Chinese customized total Temporomandibular Joint Prosthesis reconstruction cases, ChiCTR-ONC-16009712. Registered 22 Nov 2016, http://www.chictr.org.cn/showproj.aspx?proj=16091
Louis G Mercuri - One of the best experts on this subject based on the ideXlab platform.
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Temporomandibular Joint Prosthesis revision and or replacement survey and review of the literature
Journal of Oral and Maxillofacial Surgery, 2020Co-Authors: Felix Jose Amarista, Louis G Mercuri, Daniel PerezAbstract:ABSTRACT: Purpose The purpose of this study was to report Temporomandibular Joint alloplastic reconstruction (TMJR) revision and/or replacement rates and its associated complication outcome data gathered from experienced TMJ surgeons, and to review the recent relevant literature. Materials and Methods A 21-question anonymous on-line survey was sent to all Commission on Dental Accreditation-approved oral and maxillofacial surgery program directors, as well as to members of the European Society of TMJ Surgeons (ESTMJS), and the American Society of Temporomandibular Joint Surgeons (ASTMJS). Results Twenty two percent of the surgeons completed the full questionnaire. The majority of responses came from surgeons who routinely perform TMJR surgery (93.5%); 28.3% had > 30 years of experience; 73.9% were full-time academic faculty. A total of 4,638 TMJR procedures were recorded and analyzed. The incidence for TMJR revision (keeping same device) was 3% and replacement (placing a new device) was 4.9%. The most common reason for revision was heterotopic ossification (27.5%). The most common reason for replacement was infection (21.1%). Revision was successful in 86.7% and replacement in 94.6% of cases at longest follow-up reported. Conclusion Based on the data of this study, there is a low incidence and high success rate for TMJR revision and replacement.
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Temporomandibular Joint Prosthesis REVISION AND/OR REPLACEMENT SURVEY AND REVIEW OF THE LITERATURE
Journal of Oral and Maxillofacial Surgery, 2020Co-Authors: Felix Jose Amarista, Louis G Mercuri, Daniel PerezAbstract:ABSTRACT: Purpose The purpose of this study was to report Temporomandibular Joint alloplastic reconstruction (TMJR) revision and/or replacement rates and its associated complication outcome data gathered from experienced TMJ surgeons, and to review the recent relevant literature. Materials and Methods A 21-question anonymous on-line survey was sent to all Commission on Dental Accreditation-approved oral and maxillofacial surgery program directors, as well as to members of the European Society of TMJ Surgeons (ESTMJS), and the American Society of Temporomandibular Joint Surgeons (ASTMJS). Results Twenty two percent of the surgeons completed the full questionnaire. The majority of responses came from surgeons who routinely perform TMJR surgery (93.5%); 28.3% had > 30 years of experience; 73.9% were full-time academic faculty. A total of 4,638 TMJR procedures were recorded and analyzed. The incidence for TMJR revision (keeping same device) was 3% and replacement (placing a new device) was 4.9%. The most common reason for revision was heterotopic ossification (27.5%). The most common reason for replacement was infection (21.1%). Revision was successful in 86.7% and replacement in 94.6% of cases at longest follow-up reported. Conclusion Based on the data of this study, there is a low incidence and high success rate for TMJR revision and replacement.
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twenty year follow up study on a patient fitted Temporomandibular Joint Prosthesis the techmedica tmj concepts device
Journal of Oral and Maxillofacial Surgery, 2015Co-Authors: Larry M Wolford, Louis G Mercuri, Emet D Schneiderman, Reza Movahed, Will R AllenAbstract:Purpose To evaluate subjective and objective outcomes of patients receiving Techmedica (currently TMJ Concepts) patient-fitted Temporomandibular Joint (TMJ) total Joint replacement (TJR) devices after 19 to 24 years of service. Patients and Methods This prospective cohort study evaluated 111 patients operated on by 2 surgeons using Techmedica (Camarillo, CA) patient-fitted TMJ TJR devices from November 1989 to July 1993. Patients were evaluated before surgery and at least 19 years after surgery. Subjective evaluations used standard forms and questions with a Likert scale for 1) TMJ pain (0, no pain; 10, worst pain imaginable), 2) jaw function (0, normal function; 10, no movement), 3) diet (0, no restriction; 10, liquid only), and 4) quality of life (QoL; improved, the same, or worse). Objective assessment measured maximum incisal opening (MIO). Comparison analysis of presurgical and longest follow-up data used nonparametric Mann-Whitney and Wilcoxon signed rank tests. Spearman correlations evaluated the number of prior surgeries in relation to objective and subjective variables. Results Of the 111 patients, 56 (50.5%) could be contacted and had adequate records for inclusion in the study. Median follow-up was 21 years (interquartile range [IQR], 20 to 22 yr). Mean age at surgery was 38.6 years (standard deviation, 10 yr). Median number of previous TMJ surgeries was 3 (IQR, 4). Presurgical and longest follow-up data comparison showed statistically significant improvement (P < .001) for MIO, TMJ pain, jaw function, and diet. At longest follow-up, 48 patients reported improved QoL, 6 patients reported the same QoL, and 2 patients reported worse QoL. Spearman correlations showed that an increased number of previous surgeries resulted in lower levels of improvement for TMJ pain and MIO. Conclusions At a median of 21 years after surgery, the Techmedica/TMJ Concepts TJR continued to function well. More previous TMJ surgeries indicated a lesser degree of improvement. No devices were removed owing to material wear.
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Twenty-year follow-up study on a patient-fitted Temporomandibular Joint Prosthesis: the Techmedica/TMJ Concepts device.
Journal of Oral and Maxillofacial Surgery, 2014Co-Authors: Larry M Wolford, Louis G Mercuri, Emet D Schneiderman, Reza Movahed, Will R AllenAbstract:Purpose To evaluate subjective and objective outcomes of patients receiving Techmedica (currently TMJ Concepts) patient-fitted Temporomandibular Joint (TMJ) total Joint replacement (TJR) devices after 19 to 24 years of service. Patients and Methods This prospective cohort study evaluated 111 patients operated on by 2 surgeons using Techmedica (Camarillo, CA) patient-fitted TMJ TJR devices from November 1989 to July 1993. Patients were evaluated before surgery and at least 19 years after surgery. Subjective evaluations used standard forms and questions with a Likert scale for 1) TMJ pain (0, no pain; 10, worst pain imaginable), 2) jaw function (0, normal function; 10, no movement), 3) diet (0, no restriction; 10, liquid only), and 4) quality of life (QoL; improved, the same, or worse). Objective assessment measured maximum incisal opening (MIO). Comparison analysis of presurgical and longest follow-up data used nonparametric Mann-Whitney and Wilcoxon signed rank tests. Spearman correlations evaluated the number of prior surgeries in relation to objective and subjective variables. Results Of the 111 patients, 56 (50.5%) could be contacted and had adequate records for inclusion in the study. Median follow-up was 21 years (interquartile range [IQR], 20 to 22 yr). Mean age at surgery was 38.6 years (standard deviation, 10 yr). Median number of previous TMJ surgeries was 3 (IQR, 4). Presurgical and longest follow-up data comparison showed statistically significant improvement (P < .001) for MIO, TMJ pain, jaw function, and diet. At longest follow-up, 48 patients reported improved QoL, 6 patients reported the same QoL, and 2 patients reported worse QoL. Spearman correlations showed that an increased number of previous surgeries resulted in lower levels of improvement for TMJ pain and MIO. Conclusions At a median of 21 years after surgery, the Techmedica/TMJ Concepts TJR continued to function well. More previous TMJ surgeries indicated a lesser degree of improvement. No devices were removed owing to material wear.
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measurement of the heat of reaction transmitted intracranially during polymerization of methylmethacrylate cranial bone cement used in stabilization of the fossa component of an alloplastic Temporomandibular Joint Prosthesis
Oral Surgery Oral Medicine Oral Pathology, 1992Co-Authors: Louis G MercuriAbstract:Abstract Temporomandibular Joint alloplastic fossa replacements have always been difficult to stabilize because of the variability of the anatomy in the area both in normal and especially in pathologic states. Total Joint reconstruction and stabilization in orthopedic surgery have been aided by the use zof methylmethacrylate, which is used both as a cementing substance and as a filler material when there are voids between the implant and the basilar bone. The concept of the use of a filler material to aid in the stabilization of the alloplastic Temporomandibular Joint fossa is attractive, but of concern because of the exothermic reaction this material undergoes as it sets in proximity to the middle cranial fossa. This study was designed to measure the temperature gradient that exists in such a procedure when used with cadaver specimens. The results indicate that the heat of reaction was not significantly transmitted intracranially in the cadavers studied. However, I recommend care in the use of this material for this purpose with patients.
