Patient-specific Temporomandibular Joint Endoprosthesis


The temporomandibular joint (TMJ) is the most frequently used joint in the human body; its unique biomechanics allows us to speak and chew. This joint consists of the following two main structures: glenoid fossa and condylar head.
When the temporomandibular joint is damaged as a result of trauma or illness (such as osteoarthrosis, ankylosis, etc.), and usual treatment methods are ineffective or impossible to apply, this joint undergoes replacement surgery – the patient’s TMJ is replaced with an artificial one. This TMJ endoprosthesis is intended to replace a damaged joint, and restore its anatomy and its function. TMJ endoprosthesis may be either standard or patient-specific. In severe cases (for instance, large bone defect / deformity, irregular jaw position, bilateral pathology (both TMJs) or complications of existing implants), the use of a patient-specific TMJ implant is then recommended.
Ortho Baltic manufactures patient-specific TMJ endoprosthesis individually for each patient with regard to the patient’s anatomy, pathology and the surgeon’s specifications for the design and requested set. Patient-specific TMJ implants and patient-specific surgical guides are designed on the patient’s skull-mandible anatomical model that is recreated from CT scan images. If possible, we advise to perform intraoral scan or take dental impressions of patient’s teeth. These highly accurate models are used to design a bite splint (to correctly position the jaws). Therefore, the patient-specific endoprosthesis precisely fits the patient’s anatomy and ensures stable fixation and restoration of anatomical axes. The accuracy (regarding the pre-surgical plan) of resection lines, implant positioning and restoration of occlusion are ensured by using patient-specific surgical guides.

Ortho Baltic is proud to be the first patient-specific TMJ endoprosthesis manufacturer in Baltic States, and one of the few in whole Europe. More read hereAlso we would like to thank prof. dr. Jules Poukens, who participated a lot in creating solution for the our first patient-specific TMJ replacement case!

Manufacturing and materials of Ortho Baltic patient-specific TMJ endoprosthesis

Ortho Baltic is the only manufacturer in Europe that provides registered patient-specific TMJ endoprosthesis. Ortho Baltic patient-specific TMJ endoprosthesis are registered in the State Health Care Accreditation Agency under the Ministry of Health of the Republic of Lithuania. All the materials, software and hardware used to manufacture patient-specific TMJ implants and surgical guides are certified.
For patient-specific TMJ endoprosthesis components we use the following materials and production technologies:

  • patient-specific mandibular (ramus) component is made from medical Grade 5 titanium alloy Ti6Al4V using additive manufacturing technology DMLS;
  • patient specific fossa component is made from ultra-high molecular weight polyethylene UHMWPE using a 5+1 axis milling technology;
  • single-use patient-specific surgical guides, patient-specific anatomical and implant models used in presurgical planning as well as for planning and training purposes during surgeries are printed from biocompatible polymer (PA 2200, also known as Nylon-12), using additive manufacturing technology SLS;

After 3D printing and / or milling, patient-specific TMJ implant components (and surgical guides) are processed using various surface finishing technologies in order to ensure their compliance with the requirements defined by the harmonised product standards. Detailed information about patient-specific implant design, manufacture and validation process are available here.

Composition of Ortho Baltic patient-specific TMJ endoprosthesis package

The package of Ortho Baltic patient-specific TMJ endoprosthesis include the following:

  • Patient-specific TMJ implant – fossa component;
  • Patient-specific TMJ implant – mandibular component;
  • Patient-specific TMJ implant trials for fossa and mandibular components (optional);
  • Patient-specific surgical guides;
  • Patient-specific anatomical and implant models (virtual or materialized) that are intended to be used for presurgical planning;
  • Standard implant fixation screws;
  • Documentation (implant passport, instructions for use, etc.).

To fixate implants to the bone, standard surgical instruments for TMJ primary / revision endoprosthesis surgeries are used. Ortho Baltic either ensures the compatibility of the implant fixation solution with the surgeon’s / healthcare institution’s instruments or provides their own instruments for surgery.

If you would like to order a patient-specific TMJ endoprosthesis, have any questions or any specific requirements concerning the patient-specific implant package, please fill out the form below.