Influence of the Temporomandibular Joint in the Estimation of Bone Density in the Mandible through a Bone Remodelling Model

The temporomandibular joint (TMJ) plays a key role in the distribution of stresses in the mandible during mastication and consequently in the distribution of bone density, due to the interconnection between both variables through bone remodelling. Two finite element models of the mandible were compared to study the influence of the redistribution of stresses produced by the joint: a model without TMJ, but with simplified boundary conditions to replace the joint, as done in previous models; a more realistic model including the articular disc and some ligaments present in the TMJ. The stresses and strains in both models were compared through the strain energy density, used in many bone remodelling models as a measure of the mechanical stimulus. An anisotropic bone remodelling model was used to simulate the behaviour of mandible bone and to estimate its density distribution. The results showed that the TMJ strongly affects the stress distribution, the mechanical stimulus, and eventually the bone density, and not only locally in the condyle, but also in the whole mandible. It is concluded that it is utterly important to include a detailed model of the TMJ to estimate more correctly the stresses in the mandible during mastication and, from them, the bone density and anisotropy distribution.