Designing customized temporomandibular fossa prosthesis based on envelope surface of condyle movement: validation via in silico musculoskeletal simulation

Jun-Lin Wang; Jing Wang; Ke-Nan Chen; Jian-Qiao Guo; Xiang-Liang Xu; Chuan-Bin Guo

doi:10.3389/fbioe.2023.1273263

Designing customized temporomandibular fossa prosthesis based on envelope surface of condyle movement: validation via in silico musculoskeletal simulation

Front Bioeng Biotechnol. 2023 Oct 31:11:1273263. doi: 10.3389/fbioe.2023.1273263. eCollection 2023.

Authors

Jun-Lin Wang^#¹, Jing Wang^#¹, Ke-Nan Chen¹, Jian-Qiao Guo², Xiang-Liang Xu¹, Chuan-Bin Guo¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China.
² MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China.

^# Contributed equally.

Abstract

Objective: This study presents an innovative articular fossa prosthesis generated by the envelope surface of condyle movement, and compares its mandible movements, muscle activities, and joint reaction forces with two temporomandibular joint (TMJ) prostheses using multibody musculoskeletal simulation. Methods: A healthy 23-year-old female was recruited for this study. Cone-beam computed tomographic (CBCT) was performed to reconstruct the mandibular bone geometry. A customized TMJ fossa prosthesis was designed based on the subject-specific envelope surface of condyle movement (ESCM). Mandibular kinematics and jaw-closing muscle electromyography (EMG) were simultaneously recorded during maximum jaw opening-closing movements. To validate our prosthesis design, a mandibular musculoskeletal model was established using flexible multibody dynamics and the obtained kinematics and EMG data. The Biomet fossa prosthesis and the ellipsoidal fossa prosthesis designed by imitating the lower limb prostheses were used for comparison. Simulations were performed to analyze the effects of different fossa prostheses on jaw opening-closing motions, mandibular muscle activation, and contact forces. Results: The maximum opening displacement for the envelope-based fossa prosthesis was greater than those for Biomet and ellipsoidal prostheses (36 mm, 35 mm, and 33 mm, respectively). The mandibular musculoskeletal model with ellipsoidal prosthesis led to dislocation near maximal jaw opening. Compared to Biomet, the envelope-based fossa reduced the digastric and lateral pterygoid activation at maximal jaw opening. It also reduced the maximal resistance to condylar sliding on the intact side by 63.2 N. Conclusion: A customized TMJ fossa prosthesis was successfully developed using the ESCM concept. Our study of musculoskeletal multibody modeling has highlighted its advantages and potential. The artificial fossa design successfully achieved a wider condylar range of motion. It also reduced the activation of jaw opening muscles on the affected side and resistance on the intact side. This study showed that an ESCM-based approach may be useful for optimizing TMJ fossa prostheses design.

Keywords: articular fossa prosthesis; envelope surface; flexible multibody dynamics; mandibular movement; musculoskeletal simulation; temporomandibular joint.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by grants from the National Natural Science Foundations of China (grant number 12102035, 12132009), Beijing Municipal Science and Technology Commission (grant number Z201100005520055), Clinical Research Foundation of Peking University School and Hospital of Stomatology (grant number PKUSS-2023CRF205); and the Peking University Medicine Fund for World’s Leading Discipline or Discipline Cluster Development (grant number BMU2022XKQ003).