In the long-term performance of the temporomandibular joint (TMJ) implant, wear and durability must be considered. Thus retrieved and laboratory test implants were examined both optically and in a scanning electron microscope (SEM). In laboratory testing, the volumetric wear of metal-on-metal was about an 10x order of magnitude less than that of metal-on-acrylic TMJ implants. This metal-on-metal wear was also about 1/60 of that reported in the literature for a laboratory test of (UHMWPE) polyethylene-on-metal TMJ implants. The retrieved TMJ implants showed some abrasive wear occurred during multi-directional articulation with smaller wear zones for the metal-on-metal compared to the metal-on-acrylic configuration. Further efforts to characterize and minimize wear were recommended as prudent in the continuing development of TMJ arthroplasty. In TMJ laboratory wear testing, the protocol for mass loss measurements must be improved to yield realistic and repeatable mass loss values. In laboratory wear testing, multi-directional motion must be imposed in the surface articulations. Further examination of retrieved TMJ implants is required, particularly in-situ for more than 10 years. The retrieval process should include study of tissue samples collected from surrounding tissues so that both the wear particles and the response to wear particles can be studied. New approaches in design and materials should be explored to further reduce wear.

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