title: Finite element analysis of a condylar support prosthesis to replace the temporomandibular joint.
abstract: This paper presents a finite element study of a temporomandibular joint (TMJ) prosthesis in which the mandibular component sits on the condyle after removal of only the diseased articular surface and minimal amount of condylar bone. The condylar support prosthesis (CSP) is customised to fit the patient and allows a large part of the joint force to be transmitted through the condyle to the ramus, rather than relying only on transfer of the load by the screws that fix the prosthesis to the ramus. The 3-dimensional structural finite element analysis compared a design of CSP with a standard commercial prosthesis and one that was modified to fit the ramus, to relate the findings to the different designs and geometrical features. The models simulated an incisal bite under high loading. In the CSP and in its fixation screws, the stresses were much lower than those in the other 2 prostheses and the bone strains were at physiological levels. The CSP gives a more physiological form of load transfer than is possible without the condylar contact, and considerably reduces the amount of strain on the bone around the screws.
authors.affiliation: School of Engineering, Physics and Mathematics, University of Dundee, Dundee DD1 4HN, United Kingdom. Electronic address: e.w.abel@dundee.ac.uk.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Abel
authors.affiliation: School of Engineering, Physics and Mathematics, University of Dundee, Dundee DD1 4HN, United Kingdom. Electronic address: andrehilgers@yahoo.de.
authors.forename: André
authors.initials: A
authors.lastname: Hilgers
authors.affiliation: Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom. Electronic address: philip.mcloughlin@nhs.net.
authors.forename: Philip M
authors.initials: PM
authors.lastname: McLoughlin
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods; D001672:Biocompatible Materials / Q000737:chemistry; D001696:Biomechanical Phenomena; D001732:Bite Force; D001863:Bone Screws; D002858:Chromium Alloys / Q000737:chemistry; D055119:Elastic Modulus; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007595:Joint Prosthesis; D008334:Mandible / Q000502:physiology; D008335:Mandibular Condyle / Q000601:surgery; D008410:Masticatory Muscles / Q000502:physiology; D011474:Prosthesis Design; D013314:Stress, Mechanical; D013499:Surface Properties; D013704:Temporomandibular Joint / Q000601:surgery*; D014025:Titanium / Q000737:chemistry; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D001672:Biocompatible Materials; D002858:Chromium Alloys; D014025:Titanium
keywords: Condylar support; Finite element analysis; TMJ implant design; Temporomandibular joint prosthesis