南 克浩 大阪大学, 歯学部・附属病院, 医員
MORI Yoshihide Faculty of dentistry, Osaka university, Assistant professor, 歯学部, 助手 (00231639)
YAMACHIKA Eiki Faculty of dentistry, OKAYAMA UNIVERSITY, Assistant professor, 歯学部, 助手 (10294422)
MISHIMA Katsuaki Faculty of dentistry, OKAYAMA UNIVERSITY, Assistant professor, 歯学部・附属病院, 講師 (60304317)
MINAMI Katsuhiro Faculty of dentistry, Osaka university, Senior resident
|Budget Amount *help
¥13,500,000 (Direct Cost : ¥13,500,000)
Fiscal Year 2000 : ¥900,000 (Direct Cost : ¥900,000)
Fiscal Year 1999 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1998 : ¥12,100,000 (Direct Cost : ¥12,100,000)
After considering three-dimensional morphometry, stress analysis, strength, abrasion resistance of human temporomandibular joints (TMJ), we have developed an artificial TMJ only in this country. We aimed to carry out real clinical application of this artificial TMJ, and to make it advanced prothese based on analysis of effects on chewing, phonation, swallowing, respiration and facial morphological change.
1) The total replacement of the artificial TMJ was applied to the patients who were affected by chronic rheumatoid arthritis and whose TMJs were destroyed. All patients were doing well, and the results were sufficiently satisfactory as respect to function and form. Destroyed artificial TMJs were designed, and stress analysis in the clinic and simulation of jaw movement were carried out using finite element analysis.
2) Jaw movement after the total replacement of TMJ was investigated using kinegiography. In comparison with healthy subjects, jaw movement in the patients with deformative a
rthrosis was obviously restricted. After the surgery, it was confirmed that the opening quantity increased and that the masticatory efficiency heightened. However, anterior and lateral shift was limited. Some patients could not gain the opening quantity sufficiently, and in the patients atrophy of the opening muscle was observed using ultrasound image. The apnea over 60 seconds in the sleep disappeared in all patients.
3) The mandible was deformed and transferred by the deformative jaw arthritis, and the antero-posterior diameter of the upper respiratory tract was then observed. It was clarified that the antero-posterior diameter of the upper respiratory tract was improved following to the surgery. However, the antero-posterior diameter of the upper respiratory tract tended to slightly decrease in postoperative 1-2 years. Although it was not clear on this cause, respiratory condition did not become worse.
4) The effects on respiration following to the surgery : Respiratory conditions, ex. air-flowand oxygen saturation, in the patients with deformative arthrosis were analyzed quantitatively using apnea-monitor (Eden Trace). Consequently, it was shown that the respiration in the patients was improved.
5) After two-and three-dimensional stress analysis was carried out using three-dimensional finite element analysis, the artificial TMJ with more strength was designed and made.
6) To facilitate the mounting of artificial TMJ in the surgery and to raise the functionality of the artificial TMJ more and more, we have started in designing of the artificial TMJ of custom maid whom the patient individually suits. Less