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Clinical application of domestic customized 3D-printing total temporomandibular joint prostheses

ZHENG Ji-si1， ZHANG Shan-yong1， YANG Chi1， YU Yang2， JIANG Wen-bo2， LI Hui-wu3， WANG Xiang-yu1， JIAO Zi-Xian1， ZHONG Xiao-Qi1   

  1. 1.Department of Oral and Maxillofacial Surgery, Collage of Stomatology, 2.Center of 3D-Printing Translational Medicine, 3.Department of Orthopaedics, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2016-09-28 Published:2016-10-31
  • Supported by:

    National Natural Science Foundation of China, 81371168; Shanghai Committee of Science and Technology, 16441908800；Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20152226; Ministry of Science and Technology National Key Research Project， 2016YFC1100600； Key Project of Shanghai Municipal Health and Family Planning Commission， 201640001

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Abstract:

Objective· To verify the safety, efficiency, and precision of the clinical application of domestic customized 3D-printing total temporomandibular joint prostheses. Methods·2 patients with temporomandibular joint osteoarthrosis were included in this study. The maxillofacial computed tomography (CT) was performed before surgery and the CT data were input into the Mimics 18.0 software. The customized total joint prostheses were designed according to the anatomy of patients’ temporomandibular joints and were made with 3D printing. The surgeries were performed after the mechanical performance test for the prostheses. The modified preauricular approach was used and the prosthesis was placed and fixed after removing affected joint nodules and condyles. The wound was closed and sutured after occlusion was examined. The clinical follow-up and radiography examinations were performed 1 week, 1 month, and 3 months after surgery. The preoperative designed position and postoperative implant position of prosthesis in CT images were compared and the deviation was analyzed. Results·The average static yield strength of the prosthesis was 3100 N. No cracks or fractures were detected during fatigue tests. Biological examinations were qualified after disinfection and sterilization. All prostheses were positioned smoothly and firmly attached to bone surfaces. Prostheses showed no displacement, loosening, and fracture in X-ray images 1 week and 3 months after surgery. The pain, diet, and mouth opening of patients were significant improved 3 months after surgery. The fitting results of preoperative and postoperative CT images indicated that the mean error between preoperative designed position and postoperative implant position of prosthesis was (0.904±0.292) mm at the fossa and (0.528±0.198) mm at the ramus. The overall mean error was (0.878±0.259) mm. Conclusion·The domestic customized 3D-printing total temporomandibular joint prosthesis is safe and efficiency for the clinical application.

Key words: domestic total temporomandibular joint prostheses, custom-made, 3D-printing, clinical application