The All India Institute of Medical Sciences (AIIMS) has introduced a cutting-edge 3D printing technology for jaw joint replacements to acquire accuracy in such procedures.



At a three-day workshop the 2nd AIIMS Total TMJ Replacements Workshop, 2020, being is held at the Centre for Dental Education and Research (CDER) since Sunday, dental surgeons from across the country are being trained through live surgery demonstrations and practice on cadavers for this complex procedure.

"The objective of this workshop is to train these surgeons in diagnosing the cases requiring jaw joint replacements, also called total temporomandibular joint (TMJ) replacements, on time, so that future disfigurement of face is limited," Dr Ajoy Roychoudhury, the head of the Department of Oral and Maxillofacial Surgery at CDER, AIIMS, said.

He stated that the artificial joint replacements which are currently available in India are of international make and none of the Indian companies are making it on par with global standards. "This is the reason why these joint replacement procedures are expensive. AIIMS is in touch with the 3D printing industry to get medical-grade 3D-printed joints which will bring down the price substantially. Also, it will be patient-specific for best fit, longevity and reduced operating time," Roychoudhury said.

Presently, only stock joints are available which are difficult to fit in Indian patients. According to Dr Ongkila Bhutia, a professor in the Department of Oral and Maxillofacial Surgery since these jaw joints are expensive, poor patients are not able to afford it. "The government through its Rashtriya Arogya Nidhi (RAN) scheme is helping tremendously in sponsoring these joints thereby improving the quality of life of Indian poor patients," Bhutia said.

Jaw joint is the most complex and maximally used joint in human body. It helps in opening and closing the mouth, chewing food, speaking and even aids in breathing. "Sometimes, it may be absent congenitally or destroyed by trauma, infection, pathology, tumour or by some systemic autoimmune diseases. To establish normal jaw function, it should be repaired or replaced by autogenous or artificial means," Dr Rahul Yadav, associate professor in the department of oral and maxillofacial Surgery at AIIMS said.

There are two options for artificial replacement of jaw joint -- one is stock jaw joint and other is patient specific jaw joint. Due to limited size and shape of available stock joint and every patient's native bone anatomy variability, makes its use very limited. Patient-specific jaw joint is the only alternative or the best option. "Patient specific jaw joint fabrication is very costly, time-consuming, challenging and require long-term clinical experience. Fortunately, immersive 3D technology makes it more feasible and less turn around time for fabrication," Yadav said. The upper part of the joint is made up of special type high strength biocompatible plastic material fixed to skull bone with titanium screws while the lowe part is made up of 3D printed titanium material attached loer jaw with multiple titanium screw.