Replacing temporomandibular joints

The masticatory system plays an important role during biting, chewing, swallowing, speech, singing and other functions, all directly affecting quality of life. For proper functioning, both temporomandibular joints and the connecting mandible, together with the masticatory muscles and contiguous tissue components, play a major role. In a healthy situation, the masticatory muscles supply the mandible with the required movements and biting and chewing forces, while the left and right mandibular condyles slide smoothly along their articular eminences. Disturbances of the masticatory system can lead to a wide range of both muscular and Temporomandibular Joint (TMJ) conditions and pathology, resulting in pain, limited mouth opening, headaches, clicking or popping sounds in the TMJ and impaired masticatory functioning. TMJ disturbances and muscle problems influence each other and may lead to chronic pain and functional impairment. The TMJ prosthesis design is a mixture of well-known and accepted techniques, and new inventions. Among the well-known techniques are screw fixation and the use of proven biocompatible materials. The main new developments are a double articulation, including an inferiorly located centre of rotation, a self-adjusting skull part that is built from stock parts and a rigid screw-prosthesis connection

Osteoarthrosis as the cause of craniomandibular pain and dysfunction:A unifying concept

It has been demonstrated that osteoarthrotic changes in the temporomandibular joint (TMJ) and in other synovial joints show a similar course, both clinically and (ultra)microscopically. Initially, cartilage changes and possibly also changes in the synovial membrane set up a vicious cycle of cartilage breakdown accompanied by attempts at repair. When the degradative process exceeds the response of repair, the osteoarthrotic disorder progresses into clinically detectable stages. Frequently, the gliding capacity of the articular disc is also impaired, giving rise to an internal derangement. In this article, a concept is presented in which it is suggested that in many cases of craniomandibular pain and dysfunction TMJ osteoarthrosis is the basic disorde

A Proposed Classification of Temporomandibular Disorders Based on Synovial Joint Pathology

Classifying temporomandibular disorders is essential for descriptive and diagnostic reasons. The etiology of many temporomandibular joint (TMJ) disorders is unknown and lack of scientific agreement about etiologic concepts contributes to controversies about the real nature of TMJ disorders. Although many classifications have been suggested, mostly based on etiologic assumptions, a generally accepted classification is not yet available. Considering the TMJ as a true synovial joint, comparable to all other joints in the body, implies that the classification of disorders of the masticatory system should be consistent with the approach to musculoskeletal disorders in other parts of the body. Based on this criterium and on the considerable amount of information available in the literature, a classification of TMJ disorders is here proposed for general us