摘要：Total temporomandibular joint(TMJ)replacement is recommended only when there is irreversible damage to the joint and no conservative treatment can provide functional *** stock and custom-made TMJ implants have been made available;however,retrospective and comparative studies were unable to find significant differences between the two types of *** introduction of additive manufacturing(AM)techniques in medical practice allows for a greater freedom of design and a higher degree of device *** combination of AM with structural optimisation may streamline development and provide the key for fabricating biomechanic ally enhanced TMJ *** this study,structural optimis ation techniques were applied to develop and numerically validate a patient-specific TMJ *** biomechanical behaviour of each intermediate TMJ design was assessed under four different nominal and maximum biting tasks using finite element *** addition,a new set of metrics were proposed to compare each design regarding biomechanical performance and implant *** results suggest that 55-82%of the natural/intact strain patterns can be recovered with the finally selected TMJ *** represents an increase of 15%in biomechanical performance for incisor biting,15%for right molar biting,17%for left molar biting and a decrease of 2%for left group biting compared with the initial *** results also suggest that load transfer at the proximal ramus reduces the implant’s impact on the mandible’s strain ***,structural optimisation allows for a volume reduction of up to 44%with a minimum loss of implant safety and biomechanical performance.