The Foundation for Developing an Exoskeleton for the Rehabilitation of Temporomandibular Disorders

Abstract

Temporomandibular disorders affect a significant portion of the population, often causing pain and restricted jaw movement. Physiotherapy with active jaw exoskeletons seems to be a promising treatment approach. However, there has been limited progress in this area, with only a few studies published. The lack of detailed simulations and biomechanical jaw models in these papers impedes the design and validation of such devices. Thus, this work presents an open-source and extendable jaw model framework to support the development of jaw exoskeletons for TMD rehabilitation. The framework includes three model variants with varying complexity: a rigid body model with point-on-surface constraints, a rigid body model with mesh geometry constraints, and a hybrid model combining rigid dynamics with finite element methods. Model customization is facilitated through JSON configuration files, requiring minimal programming expertise. The framework was evaluated using experimental kinematic data from a single participant, with muscle excitations computed via PID controllers tuned through global optimization. The models successfully reproduced jaw movements without prior individualization, demonstrating their suitability for prototyping and studying exoskeleton behavior. The basic models are ideal for rapid prototyping, while the hybrid model provides insights into the effects of exoskeletons on the masticatory system. This framework establishes a foundation for advancing jaw exoskeleton development, with future work focusing on patient-specific modeling, improved anatomical detail, and tools for exoskeleton control and design. The framework code is publicly available and can be found at https://github.com/paulotto/exosim.