Development and application of Chinese customized total temporomandibular joint prosthesis
CHEN Xuzhuo,, MAO Yi, YUAN Dan,, ZHANG Shanyong,, YANG Chi
Department of Oral Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
Alloplastic total joint replacement is one of the effective methods for temporomandibular joint (TMJ) reconstruction. As the first choice for TMJ reconstruction, alloplastic total joint replacement has the advantages of no need to open up a second operative area, short operation duration and immediate functional restoration, compared with autogenous bone graft. The customized prosthesis has the edge over the stock prosthesis due to its excellent suitability and less intraoperative bone trimming. However, there are no commercialized counterparts in China yet. Hence, it is urgent to develop a Chinese customized total TMJ prosthesis for Chinese patients. Since 2009, the authors′ team has begun to develop the customized total TMJ prostheses suitable for Chinese anatomical features independently. Through three generations of products, the team gradually realized the stable connection of porous titanium alloys and ultra-high molecular weight polyethylene (UHMWPE), and finally achieved a key technological breakthrough in 2017. The third generation of customized total TMJ prosthesis was successfully developed by friction stir welding technology. The mechanical properties of Chinese customized prostheses have prevailed over its international counterparts, with satisfactory short-term follow-up results based on its preliminary clinical application. Furthermore, in order to ensure high efficiency and accuracy of the procedures from design and manufacture to clinical application, the authors′ team has developed a relatively mature standardized process, and improved the surgical procedures. This review systematically summarizes the research and development of Chinese customized total TMJ prosthesis system in the past decade, and looks forward to the future development of Chinese customized prosthesis system.
Keywords：total temporomandibular joint replacement
;
customized prosthesis
;
made in China
;
friction stir welding
;
3D printing
CHEN Xuzhuo, MAO Yi, YUAN Dan, ZHANG Shanyong, YANG Chi. Development and application of Chinese customized total temporomandibular joint prosthesis. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2023, 43(5): 524-531 doi:10.3969/j.issn.1674-8115.2023.05.002
Note： A. The first generation of trial product. B. The second generation of prosthesis, and the fossa was totally made of UHMWPE. C. The third generation of TC4-UHMWPE-connected fossa prosthesis. D. Clinical implantation of the third generation of prosthesis.
Fig 1
Development of Chinese customized total TMJ prosthesis system
Note： A. Fixation of the mandibular prosthesis assisted by endoscopy. B. The dead space filled with buccal fat pads. C. Zygomatic arch osteotomy and prosthesis positioning guided by digital templates. D. Mandibular osteotomy and prosthesis position guided by digital templates.
Fig 3
Surgical improvements for the third generation of Chinese customized total TMJ prostheses
The manuscript was drafted by CHEN Xuzhuo and MAO Yi, and reviewed and revised by YUAN Dan, ZHANG Shanyong and YANG Chi. All the authors have read the last version of paper and consented for submission.
利益冲突声明
所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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