顳顎關節是人體最重要的關節之一。當顳顎關節發生病變時會讓患者在日常生活起居中產生極大 的?方?和痛苦。文獻指出，約有40%的人口皆發生過顳顎關節疼痛或功能障礙，基本上，大部分的 顳顎關節障礙症都可以藉由物?治?和咬和調整等方式?進?治?，但對於嚴重的顳顎關節病變如： 關節僵硬症、腫瘤、嚴重的關節炎等無法由上述治?方式?改善原有的問題，則需要進?人工顳顎關 節置換手術。雖然過去已有探討全人工顳顎關節的研究，但絕大多是?床醫學報告，對於顳顎關節植 入物本身並沒有做深入的研究與分析。並且從生物?學的角??看，以往人工髖關節以及人工牙根的 經驗可知，植體植入骨頭中，在承受長期肌肉施加的負載作用?激下，骨質會開始產生重塑?為，有 可能導致植體周圍骨質的生成和吸收達到?平衡而產生骨質及骨?的?失，造成植體?穩定而失敗。 本研究計畫?用電腦斷層掃瞄影像及電腦輔助繪圖軟體建?下顎骨及人工顳顎關節莖之有限元素模 型，將骨質重塑??(bone-remodeling theory)結合有限元素法，先發展一套模擬手術後人工顳顎關節莖 周圍骨質重塑(?失)?態的技術，再探討?同人工顳顎關節材質及固定方式(鎖入?同?絲?目、位置) 對植體周邊骨質重塑方式的影響。
The temporomandibular joint (TMJ) is an important joint of the human skeleton. The temporomandibular diseases can induce oral pain and significant inconvenience. Reviewing the previous literatures, around 40% of the population have some signs or symptoms of temporomandibular disease. These patients can often be managed medically with nonsteroidal anti-inflammatory drugs, physiotherapy, and intra-articular injection of steroids. However, patients with serious osteoarthristis, rheumatoid arthritis, psoriatic arthritis and ankylosis might be good candidates for the receiving a TMJ prosthesis. Most of the many published papers related to the TMJ have been clinical and case reports. From the biomechanical viewpoint, especially based on the experiences of the total hip replacement and the dental implant, the marginal bone lost and the structure of cancellous bone changed around implants in the long-term causing bone resorption might result in implant system failure. In this proposal, the three-dimensional finite element models of the mandibular bone and artificial TMJ prosthesis will be created based on computed tomography images and commercial implants, respectively. Then, we plan to combine the bone-remodeling theory and finite element analysis to develop a technique to simulate bone remodeling situations around implant before surgery, and to execute multiple stage simulation of the bone remodeling with the different materials and fixation method (number of screws) of the artificial TMJ prosthesis.
