Muscle and joint mechanics during maximum force biting following total temporomandibular joint replacement surgery

IF 3 3区医学 Q2 BIOPHYSICS Biomechanics and Modeling in Mechanobiology Pub Date : 2024-03-19 DOI:10.1007/s10237-023-01807-1

Sarah C. Woodford, Dale L. Robinson, Jaafar Abduo, Peter V. S. Lee, David C. Ackland

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Abstract

Total temporomandibular joint replacement (TMJR) surgery is the established treatment for severe temporomandibular joint disorders. While TMJR surgery is known to increase mouth-opening capacity, reduce pain and improve quality of life, little is known about post-surgical jaw function during activities of daily living such as biting and chewing. The aim of this study was to use subject-specific 3D bite force measurements to evaluate the magnitude and direction of joint loading in unilateral total TMJR patients and compare these data to those in healthy control subjects. An optoelectronic tracking system was used to measure jaw kinematics while biting a rubber sample for 5 unilateral total TMJR patients and 8 controls. Finite element simulations driven by the measured kinematics were employed to calculate the resultant bite force generated when compressing the rubber between teeth during biting tasks. Subject-specific musculoskeletal models were subsequently used to calculate muscle and TMJ loading. Unilateral total TMJR patients generated a bite force of 249.6 ± 24.4 N and 164.2 ± 62.3 N when biting on the contralateral and ipsilateral molars, respectively. In contrast, controls generated a bite force of 317.1 ± 206.6 N. Unilateral total TMJR patients biting on the contralateral molars had a significantly higher lateral TMJ force direction (median difference: 63.6°, p = 0.028) and a significantly lower ratio of working TMJ force to bite force (median difference: 0.17, p = 0.049) than controls. Results of this study may guide TMJ prosthesis design and evaluation of dental implants.

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全颞下颌关节置换手术后最大咬合力时的肌肉和关节力学特性

全颞下颌关节置换（TMJR）手术是治疗严重颞下颌关节疾病的成熟疗法。众所周知，颞下颌关节置换手术能提高张口能力、减轻疼痛并改善生活质量，但人们对手术后颌骨在咬合和咀嚼等日常生活活动中的功能知之甚少。本研究的目的是使用特定受试者的三维咬合力测量来评估单侧全颞下颌关节置换术患者关节负荷的大小和方向，并将这些数据与健康对照受试者的数据进行比较。我们使用光电跟踪系统测量了 5 名单侧全颞下颌关节病患者和 8 名对照组患者咬橡胶样本时的下颌运动学特性。利用测量到的运动学数据进行有限元模拟，计算在咬合任务中压缩牙齿间的橡胶时产生的咬合力。随后使用特定受试者的肌肉骨骼模型来计算肌肉和颞下颌关节的负荷。单侧全颞下颌关节复位患者在咬对侧臼齿和同侧臼齿时产生的咬合力分别为 249.6 ± 24.4 N 和 164.2 ± 62.3 N。与对照组相比，单侧全颞下颌关节复位患者咬合对侧磨牙时的颞下颌关节外侧力方向（中位数差异：63.6°，p = 0.028）明显更高，颞下颌关节工作力与咬合力的比率（中位数差异：0.17，p = 0.049）明显更低。这项研究的结果可为颞下颌关节假体的设计和牙科植入物的评估提供指导。

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来源期刊

Biomechanics and Modeling in Mechanobiology 工程技术-工程：生物医学

CiteScore

7.10

自引率

8.60%

发文量

119

审稿时长

6 months

期刊介绍： Mechanics regulates biological processes at the molecular, cellular, tissue, organ, and organism levels. A goal of this journal is to promote basic and applied research that integrates the expanding knowledge-bases in the allied fields of biomechanics and mechanobiology. Approaches may be experimental, theoretical, or computational; they may address phenomena at the nano, micro, or macrolevels. Of particular interest are investigations that (1) quantify the mechanical environment in which cells and matrix function in health, disease, or injury, (2) identify and quantify mechanosensitive responses and their mechanisms, (3) detail inter-relations between mechanics and biological processes such as growth, remodeling, adaptation, and repair, and (4) report discoveries that advance therapeutic and diagnostic procedures. Especially encouraged are analytical and computational models based on solid mechanics, fluid mechanics, or thermomechanics, and their interactions; also encouraged are reports of new experimental methods that expand measurement capabilities and new mathematical methods that facilitate analysis.