WO2024259475A1 - Implant de remplacement d'articulation temporo-mandibulaire - Google Patents

Implant de remplacement d'articulation temporo-mandibulaire Download PDF

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Publication number
WO2024259475A1
WO2024259475A1 PCT/AU2024/050631 AU2024050631W WO2024259475A1 WO 2024259475 A1 WO2024259475 A1 WO 2024259475A1 AU 2024050631 W AU2024050631 W AU 2024050631W WO 2024259475 A1 WO2024259475 A1 WO 2024259475A1
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WO
WIPO (PCT)
Prior art keywords
joint replacement
temporomandibular joint
accordance
replacement implant
defines
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/AU2024/050631
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English (en)
Inventor
Stefan Medio
Nathan Wang
George Dimitroulis
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Maxoniq Ip Pty Ltd
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Maxoniq Ip Pty Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from AU2023901938A external-priority patent/AU2023901938A0/en
Application filed by Maxoniq Ip Pty Ltd filed Critical Maxoniq Ip Pty Ltd
Publication of WO2024259475A1 publication Critical patent/WO2024259475A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30934—Special articulating surfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A61F2002/30991—Mandibular components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30988—Other joints not covered by any of the groups A61F2/32 - A61F2/4425
    • A61F2/3099—Other joints not covered by any of the groups A61F2/32 - A61F2/4425 for temporo-mandibular [TM, TMJ] joints
    • A61F2002/30993—Temporal components
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0095—Saddle-shaped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00011—Metals or alloys
    • A61F2310/00023—Titanium or titanium-based alloys, e.g. Ti-Ni alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00395—Coating or prosthesis-covering structure made of metals or of alloys
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00389—The prosthesis being coated or covered with a particular material
    • A61F2310/00592—Coating or prosthesis-covering structure made of ceramics or of ceramic-like compounds

Definitions

  • the present invention relates generally to an improved type of temporomandibular joint replacement implant.
  • Osteoarthritis of the human temporomandibular joint can result in severe debilitating jaw pain and dysfunction. End stage joint diseases such as osteoarthritis are destructive to all parts of the temporomandibular joint which may require the complete surgical removal of the joint.
  • Ultra-high Molecular Weight Polyethylene UHMWPE
  • Vitallium Cobalt/Chromium/Molybdenum
  • Titanium Ti-6AI-4V
  • temporomandibular joint prosthetic systems have metallic condylar heads which articulate against an UHMWPE fossa lining.
  • the fossa component may either be made wholly of UHMWPE or may be a hybrid version of titanium alloy backing fixed to the cranial base with an UHMWPE liner that is connected by various chemical or mechanical fixings.
  • the foregoing objects should not necessarily be considered as cumulative and various aspects of the invention may fulfil one or more of the above objects.
  • the invention could be broadly understood to comprise a temporomandibular joint replacement implant comprising a fixable fossa, constructed at least partly from a metallic material, which engages a non-metallic condylar head of a jaw component/ramus portion.
  • a temporomandibular joint replacement implant comprising: a fossa component; a jaw component, wherein: the fossa component defines a metallic articular surface; and the jaw component includes a non-metallic condylar portion engaging the metallic articular surface.
  • the condylar portion or a part thereof, is reversibly engageable with the jaw component.
  • the fossa component is constructed substantially from a metallic material, and may be selected from a group including titanium.
  • the non-metallic condylar portion is preferably constructed from a polymeric material and/or a ceramic material.
  • the polymeric material comprises an Ultra-high Molecular Weight Polyethylene (UHMWPE).
  • UHMWPE Ultra-high Molecular Weight Polyethylene
  • the jaw component defines a ramus portion which is preferably formed from a metallic material.
  • the condylar portion defines a mediolateral elongate axis in a transverse plane.
  • the condylar portion may be ovular in the transverse plane.
  • the jaw component defines a ramus portion wherein the condylar portion predominantly extends medially with respect to the ramus portion.
  • the metallic articular surface defines a mediolateral elongate axis in the transverse plane, wherein the fossa component defines a lateral flange in a sagittal plane and wherein the metallic articular surface predominantly extends medially with respect to the lateral flange.
  • the metallic articular surface When in the sagittal plane, the metallic articular surface defines a posterior backstop, which may be defined by a posterior wall of substantially uniform thickness.
  • the metallic articular surface When in the sagittal plane, the metallic articular surface defines a posterior region and an anterior region and wherein the posterior portion tends to a greater angle with respect to a transverse plane as compared to the anterior portion.
  • the articular surface When in the sagittal plane, the articular surface defines a posteriorly located apex.
  • the jaw component defines a ramus portion, wherein the condylar portion is removeable from the ramus portion.
  • the ramus portion preferably defines a superior key that fits an inferior socket of the polymeric condylar portion.
  • the key and the socket may be non-rotationally keyed together.
  • the condylar portion may define an ovular section capped by a domed section.
  • the key defines longitudinal indentations and wherein the socket defines longitudinal protrusions which key into the longitudinal indentations.
  • the cross-section of the key and socket may therefore be nonsymmetric along a longitudinal axis thereof.
  • the key generally defines a first side screw hole, which may be blind.
  • the condylar portion defines a second side screw hole, which is preferably a through hole.
  • the condylar portion in one form, defines an annular interface for the second side screw hole.
  • the annular interface defines an annular portion such that a head of a screw, being configured to engage the first screw hole and second screw hole, can be countersunk.
  • the annular interface comprises a cap which closes over a head of the screw.
  • the present temporomandibular joint replacement implant has the articulating bearing components of the prior art essentially reversed, wherein metal forms the fixed articulating surface covering the base of skull (i.e. the fossa component) and the mobile condylar head being composed of polymer bearing material such as UHMWPE, or a ceramic bearing material.
  • the fixed fossa component may be made entirely of metal alloy such as titanium (Ti-6AI-4V) and opposing a mobile condylar head covered by a thick UHMWPE liner attached to a ramus portion unit.
  • the ramus portion being constructed from a metal alloy such as titanium.
  • the prosthetic fossa component protects the bony skull base of the patient from wear and perforation into the cranial cavity resulting from the constant frictional motion of the prosthetic condylar head. While previous temporomandibular joint prosthetic systems have incorporated UHMWPE into their fossa design, the present temporomandibular joint replacement implant has a fossa of metal alloy.
  • the thin metal fossa lining the skull base allows for a more natural positioning of the condyle's head, improving the axis of rotation and avoiding jaw deviation during mandible movement.
  • the fossa may have a posterior backing which provides protection to the tympanic plate and middle ear from the functional pressures exerted by the condylar head.
  • the metal fossa's posterior backing enables the condylar head to be seated in a fixed position, ensuring a stable occlusion and facilitating orthognathic surgical procedures if necessary.
  • the UHMWPE cap covering the condylar head can either be permanently fixed or designed as a removable component.
  • the latter option allows for the replacement of the UHMWPE cap, preserving the metallic components of the joint implant during revision surgeries rather than requiring removed each time.
  • a method of temporomandibular joint replacement including the steps of: providing a temporomandibular joint replacement implant in accordance with any one of the above aspects; preparing the implant site for implantation of the fossa component; attaching the fossa component at the implant site; and engaging the jaw component to the fossa component wherein the non-metallic condylar portion engages the metallic articular surface of the fossa component.
  • Figure 1 is a perspective view of a jaw component of a first embodiment of a temporomandibular joint replacement implant of the present invention
  • Figure 2 is a lateral side view of a fossa component of the implant of the present invention
  • Figure 3 is a medial side view of the fossa component of Figure 2;
  • Figure 4 is a posterior view of the fossa component of Figure 2;
  • Figure 5 is a schematic perspective view of a condylar portion of the jaw component of Figure 1 ;
  • Figure 6 is a perspective view of a key, in accordance with one embodiment, of jaw component of Figure 1 configured for engaging the condylar portion of Figure 5;
  • Figure 7 is a perspective view of the condylar portion of Figure 5;
  • Figure 8 is a perspective view of the condylar portion of Figure 7 aligned with the key of Figure 6, for engagement therewith;
  • Figure 9 is a cross-sectional view of the condylar portion of Figure 1 ;
  • Figure 10 is an underside view of a second embodiment of the condylar portion
  • Figure 11 is a perspective view of the condylar portion of Figure 10;
  • Figure 12 is a side view of the condylar portion of Figure 10;
  • Figure 13 is a perspective view of the jaw component of a second embodiment of the temporomandibular joint replacement implant
  • Figure 14 is a partial view of the ramus portion of the jaw component of Figure 13, illustrating the key, in accordance with a second embodiment configured for engaging the condylar portion of Figure 10;
  • Figure 15 is a side view of the ramus portion of the jaw component of a third embodiment.
  • Figure 16 is a perspective view of the ramus portion of Figure 15.
  • the temporomandibular joint replacement implant comprises a fossa component 101 and a jaw component 102.
  • the fossa component 101 is configured to be fixed to the base of the cranium of a patient, and the jaw component 102 attaches to the resected jaw of the patient.
  • the fossa component 101 defines a metallic articular surface 103 and the jaw component 102 comprises a non-metallic condylar portion 104, which articulates against the articular surface 103 of the fossa component 101.
  • the fossa component 101 will be constructed entirely from a metallic material, and in one embodiment may be made of a titanium alloy.
  • the polymeric condylar portion 104 comprises a polymeric material, and in one embodiment comprises Ultra-high Molecular Weight Polyethylene (UHMWPE).
  • UHMWPE Ultra-high Molecular Weight Polyethylene
  • the condylar portion 102 may be constructed from a ceramic material.
  • the jaw component 102 may define a ramus portion 105.
  • the ramus portion 105 may be metallic, and in one embodiment is entirely metallic. As shown in Figure 1 , the ramus portion 105 may be split into an anterior portion 106 and a posterior portion 107 defining a substantially inverted teardrop shaped aperture therebetween.
  • the posterior portion 107 may include a plurality of screw holes 108 for bone screws to engage the ascending ramus of the patient’s jaw.
  • the condylar portion 104 may define a mediolateral elongate axis 109 in the transverse plane.
  • Figure 9 illustrates one embodiment the condylar portion 104 which is substantially ovular in the transverse plane. Shown in Figure 9 is a lateral end 110 and a medial end 111 of the condylar portion 104. As shown in Figure 1 , the condylar portion 104 may extend predominantly medially with respect to the ramus portion 105.
  • the articular surface 103 may similarly define a mediolateral elongate axis 112 in the transverse plane.
  • the fossa component 101 may define a lateral flange 103 having screw holes 114 therethrough for use in the attachment to the side of the base of the skull.
  • the articular surface 103 may predominantly extend medially with respect to the lateral flange 113.
  • the articular surface 103 may define a posterior backstop 115.
  • the posterior backstop 115 may be defined by a posterior wall 116.
  • the posterior wall 116 may be of substantial uniform thickness. With reference to Figure 4, the posterior wall 116 may taper inferiorly.
  • the articular surface 113 may define an anterior region 117 and a posterior region 118 and wherein the posterior region 118 tends to a greater angle with respect to the transverse plane as compared to the anterior region 117.
  • the articular surface 103 may define a posterior located apex 119.
  • the condylar portion 104 is removable from the ramus portion 105.
  • the ramus portion 105 may define a superior key 120 that is configured to engage an inferior socket 121 of the polymeric condylar portion 104. Illustrated in Figure 6, the key 120 may have a smaller cross-section as compared to a crosssection of an adjacent portion 122.
  • the key 120 and the socket 121 may be non-rotationally keyed.
  • the key 120 defines longitudinal indentations 123 and wherein the socket 121 defines longitudinal protrusions 124 which non-rotatably key into the longitudinal indentations 123.
  • the cross-section of the key 120 and socket 121 may be nonsymmetric along a longitudinal axis so that the condylar portion 104 cannot be accidentally attached in the incorrect orientation.
  • the condylar portion 104 may comprise an ovular section 128 capped by a domed portion 129. In the sagittal plane, the domed portion may define a radius less than that defined by the articular surface 103.
  • the key 120 may define a side screw hole 125.
  • the side screw hole 125 is preferably accessibly located on the lateral side of the key 120.
  • the screw hole 125 in the present embodiment is a blind hole.
  • the condylar portion 104 may define a side screw hole 126 which may be a through hole so that a fixation screw (not shown) can be inserted through the screw hole 126 of the condylar portion 104 into the screw hole 125 of the key 120 to thereby attach the condylar portion 104 to the key 120.
  • the condylar portion 104 may define an interface 127 surrounding the side screw hole 126.
  • the interface 127 may define an annular portion so that a head of the screw can be countersunk.
  • the interface 127 may be a cap which closes over the head of the screw.
  • FIGs 10 to 12 illustrate another embodiment of the removable condylar portion 104, which includes an elongate socket 121.
  • the elongate socket 121 is dimensioned to engage the correspondingly shaped key 120 which is formed on the ramus portion 105, as illustrated in Figure 14.
  • the ramus portion 105 is generally elongate and includes the anterior portion 106 and the posterior portion 107.
  • the ramus portion 105 includes two rows of screw holes 108 for bone screws to engage the ascending ramus of the patient’s jaw.
  • the invention provides a temporomandibular joint replacement implant which allows for a more natural positioning of the condyle's head, improving the axis of rotation and inhibiting jaw deviation during mandible movement.
  • the fossa may have a posterior backing which provides protection to the tympanic plate and middle ear from the functional pressures exerted by the condylar head.
  • the metal fossa's posterior backing also enables the condylar head to be seated in a fixed position, ensuring a stable occlusion and facilitating orthognathic surgical procedures if necessary.
  • the UHMWPE cap covering the condylar head can either be permanently fixed or designed as a removable component.

Landscapes

  • Health & Medical Sciences (AREA)
  • Plastic & Reconstructive Surgery (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un implant de remplacement d'articulation temporo-mandibulaire comprenant une composante fosse, une composante mâchoire, la composante fosse définissant une surface articulaire métallique et la composante mâchoire comprenant une partie condylienne non métallique venant en prise avec la surface articulaire métallique. La composante fosse peut être entièrement constituée d'un alliage métallique tel que le titane et vient en prise avec une tête condylienne mobile recouverte par un revêtement UHMWPE épais fixé à une composante mâchoire constituée d'un alliage métallique tel que le titane.
PCT/AU2024/050631 2023-06-19 2024-06-17 Implant de remplacement d'articulation temporo-mandibulaire Pending WO2024259475A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AU2023901938A AU2023901938A0 (en) 2023-06-19 A temporomandibular joint replacement implant
AU2023901938 2023-06-19

Publications (1)

Publication Number Publication Date
WO2024259475A1 true WO2024259475A1 (fr) 2024-12-26

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/AU2024/050631 Pending WO2024259475A1 (fr) 2023-06-19 2024-06-17 Implant de remplacement d'articulation temporo-mandibulaire

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Country Link
WO (1) WO2024259475A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU202290U1 (ru) * 2020-03-06 2021-02-10 Астемир Икрамович Шайхалиев Эндопротез суставной ямки и мыщелкового отростка височно-нижнечелюстного сустава обеспечивающий синхронную экскурсию нижней челюсти
WO2022090265A1 (fr) * 2020-10-27 2022-05-05 Karl Leibinger Medizintechnik Gmbh & Co. Kg Prothèse d'articulation temporo-mandibulaire implantable, procédé de production correspondant et prothèse d'articulation temporo-mandibulaire
US20230048455A1 (en) * 2021-08-11 2023-02-16 Lawrence Battista Mobile bearing prosthetic implant system

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU202290U1 (ru) * 2020-03-06 2021-02-10 Астемир Икрамович Шайхалиев Эндопротез суставной ямки и мыщелкового отростка височно-нижнечелюстного сустава обеспечивающий синхронную экскурсию нижней челюсти
WO2022090265A1 (fr) * 2020-10-27 2022-05-05 Karl Leibinger Medizintechnik Gmbh & Co. Kg Prothèse d'articulation temporo-mandibulaire implantable, procédé de production correspondant et prothèse d'articulation temporo-mandibulaire
US20230048455A1 (en) * 2021-08-11 2023-02-16 Lawrence Battista Mobile bearing prosthetic implant system

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
WOLFORD LARRY M., PUSHKAR MEHRA: "Custom-made total joint prostheses for temporomandibular joint reconstruction", BUMC PROCEEDINGS, vol. 13, no. 2, 1 April 2000 (2000-04-01), pages 135 - 138, XP093258553 *

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