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Bio-Design and Manufacturing  2022 Vol.5 No.2 P.333-347

http://doi.org/10.1007/s42242-021-00174-z


Structural optimization of patient-specific temporomandibular joint replacement implants for additive manufacturing: novel metrics for safety evaluation and biomechanical performance


Author(s):  Manuel Pinheiro, Anouar Krairi, Robin Willaert, Maria C. Costa & Wim Van Paepegem

Affiliation(s):  Mechanics of Materials and Structures (MMS), Ghent University, Ghent, Belgium; more

Corresponding email(s):   manuel.dasilvapinheiro@ugent.be

Key Words:  Temporomandibular joint, Additive manufacturing, Implant safety, Biomechanical performance, Finite element analysis


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Manuel Pinheiro, Anouar Krairi, Robin Willaert, Maria C. Costa & Wim Van Paepegem . Structural optimization of patient-specific temporomandibular joint replacement implants for additive manufacturing: novel metrics for safety evaluation and biomechanical performance[J]. Journal of Zhejiang University Science D, 2022, 5(2): 333-347.

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Abstract: 
Total temporomandibular joint (TMJ) replacement is recommended only when there is irreversible damage to the joint and no conservative treatment can provide functional improvements. Several stock and custom-made TMJ implants have been made available; however, retrospective and comparative studies were unable to find significant differences between the two types of solutions. The introduction of additive manufacturing (AM) techniques in medical practice allows for a greater freedom of design and a higher degree of device customisation. The combination of AM with structural optimisation may streamline development and provide the key for fabricating biomechanically enhanced TMJ implants. In this study, structural optimisation techniques were applied to develop and numerically validate a patient-specific TMJ implant. The biomechanical behaviour of each intermediate TMJ design was assessed under four different nominal and maximum biting tasks using finite element analyses. In addition, a new set of metrics were proposed to compare each design regarding biomechanical performance and implant safety. The results suggest that 5582% of the natural/intact strain patterns can be recovered with the finally selected TMJ implant. This represents an increase of 15% in biomechanical performance for incisor biting, 15% for right molar biting, 17% for left molar biting and a decrease of 2% for left group biting compared with the initial design. The results also suggest that load transfer at the proximal ramus reduces the implants impact on the mandibles strain patterns. Finally, structural optimisation allows for a volume reduction of up to 44% with a minimum loss of implant safety and biomechanical performance.

特大学Manuel Pinheiro等 | 增材制造个性化颞下颌关节置换植入物的结构优化:安全性评估和生物力学性能的新指标

本研究论文聚焦下颌关节置换植入物的设计优化与性能评估研究。仅当关节有不可逆的损伤且保守治疗不能改善功能时,才建议进行全颞下颌关节 (TMJ) 置换术。现阶段已经出现了几种库存和定制的TMJ植入物可供选择。然而,综述性和比较性研究无法发现两种解决方案之间的显著差异。在医疗实践中引入增材制造技术可以实现更大的设计自由度和更高程度的定制化器械。增材制造技术与结构优化的结合可以使开发过程简化,并为制造生物力学增强的颞下颌关节植入物提供关键技术支持。在本研究中,应用结构优化技术来开发和数值验证患者特异性颞下颌关节植入物。本文使用有限元分析,在四个不同的标称和最大咬合指标下评估每种中间TMJ设计的生物力学行为。此外,本研究还提出一组新的指标来比较每个设计在生物力学性能和植入物安全性方面的差异。结果表明,最终选择的颞下颌关节植入物可以恢复55%-82%的自然/完整应变模式。与初始设计相比,门牙咬合力的生物力学性能提高了15%,右臼齿咬合力提高了15%,左臼齿咬合力提高了17%,左组咬合力降低了2%。结果还表明,近端支路的负荷转移减少了植入物对下颌骨应变模式的影响。最后,结构优化使得体积减少高达44%,同时将种植体安全性和生物力学性能的损失降至最低。

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