Temporo Mandibular Joint Groningen

The temporomandibular joint (TMJ) is one of the most special joints in the human body. The joint allows both rotation and translation. Problems with this joint can lead to problems in chewing and speaking. When non-surgical approaches fail to alleviate these problems and pain and functional impairment are affecting the patient’s quality of life, the TMJ needs to be replaced with a prosthetic TMJ. In this case, a custom-made TMJ prosthesis is obviously preferred over a standard TMJ prosthesis.

Pre-planned and perfect fit

The Xilloc TMJ prosthesis is developed in collaboration with the UMCG and is based on the proven principle of the Groningen temporomandibular total joint prosthesis. By starting from the CT-data of the patient, we now made this a patient-specific TMJ prosthesis. 

Resection of the condyle is pre-operatively planned and surgical guides are provided to perform the resection according to planning. The surgical guides also serve as drill guides to pre-drill the fixation holes in the pre-planned directions.

Screw fixation is planned based on the local bone thickness and quality. To achieve a more mechanically stable fixation, locking screws are fitted.

The titanium parts are designed to follow the surface of the mandible and skull and therefore provide a perfect fit on the anatomy of the patient.

Advantages

  • Perfect, patient-specific fit
  • Highly accurate placement
  • More natural rotation and translation
  • Pre-planned resection and drilling
  • Low-friction interfaces

Guided resection of the condyle, combined with guided pre-drilling of the fixation holes

3D printed titanium

The prosthesis comes in three parts; the skull and mandibular part are 3D printed in Ti6Al4V. The mandibular part is equipped with a highly durable Zirconium dioxide tapered ball and the skull part contains a Zirconium dioxide plate. An UHMWPE disk is connecting these parts in order to provide perfect and smooth rotation and translation. The UHMWPE – Zirconium dioxide interfaces ensure much lower friction than a titanium – UHMWPE interface.

References

De Bont L. et al. A short-term study in sheep with the Groningen temporomandibular joint prosthesis.

Van Loon J. P. et al. Fitting a temporomandibular joint prosthesis to the skull

De Bont L. et al. Design and wear testing of a temporomandibular joint prosthesis articulation.

Van Loon J. P. et al. Wear-testing of a temporomandibular joint prosthesis: UHMWPE and PTFE against a metal ball, in water and in serum.

Van Loon J. P. et al. The theoretical optimal center of rotation for a temporomandibular joint prosthesis: a three-dimensional kinematic study.

Spijkervet F. K. L. et al. Groningen temporomandibular total joint prosthesis: An 8-year longitudinal follow-up on function and pain

Courtesy of:

Prof Spijkervet

CMF surgeon, UMC Groningen, The Netherlands