Page 368 - Demo

Chapter 14366Chapter 2 provided an insight in the historical evolution of the prosthetic treatment of the TMJ, by means of a systematic review. Forty-one articles were included and discussed. The evolution in different materials and implant designs, starting from a simple interpositional wooden block to a CAD-CAM 3D-printed PSI, were discussed. This led to the conclusion that the historic development of the alloplastic TMJR was mainly a process of trial and error. Principles in design as well as materials that were applied in orthopedic surgery were transferred into the field of TMJ surgery, despite not always being suitable. This led to the use of both unsuited implant design, such as the solitary use of a condylar prosthesis, as well as the implantation of incompatible materials. Although this resulted in the need to explant several thousand prosthesis and a near loss of confidence in the TMJ TJR, it also led to further insights in the development of modern, successful TMJR.The 3rd chapter further focused on the materials that were and are being used in past and current prosthetic systems, through a narrative review. A total of 53 articles were included by means of a systematic review, with 8 more articles being handpicked from specialized literature. The properties a material needs to meet as a prosthetic material were highlighted, ranging from its biocompatibility, to its potential for osseointegration, as well as its functionality. The materials used in current TMJR were evaluated for these properties, to determine their advantages and shortcomings. Future materials, as well as surface modification techniques were then discussed to determine if current materials can be improved upon. We concluded that the use of titanium should be preferred over cobalt-chromium alloys and the use of metal-on-UHMWPE is superior to metal-on-metal articulations. We also concluded that the properties of titanium can be further improved upon through the use of surface modification techniques.This 4th chapter aimed to determine the efficacy between a patientspecific and a stock TMJ TJR. A systematic review and meta-analysis were performed, in which the maximal mouth opening, pain and diet were analyzed. Although no significant difference was found between the two types of implants, several confounding factors such as the lack Nikolas de Meurechy NW.indd 366 05-06-2024 10:15