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Chapter 5138The fossa component was ɣ-irradiated (100 kGy, Gammatom s.r.l. Como, Italy) to increase the number of crosslinks in the UHMWPE and for sterilization purposes. Ti alloy screws (Ti6Al4V grade 5, 2.0-mm diameter; Surgi-Tec NV) were used for fixation of the fossa component. Both the screws and condylar component were 40 minutes autoclaved in a 134° C - 5 minutes cycle.Surgical protocolThe left side of the face was aseptically prepared after orotracheal intubation and antibiotics (Enrofloxacin 5 mg/kg (Floxadil, EMDOKA BVBA, Hoogstraten, Belgium)) were administered at the start of surgery, up until 5 days post-operatively. The joint was accessed through both an incision over the posterior lower border of the mandible and a preauricular S-shaped incision inferior to the zygomatic arch. Once proper access was obtained, a patient/prosthesis specific Ti alloy (Ti6Al4V ELI, grade 23, CADskills BV, Ghent, Belgium) cutting guide was fixed onto the vertical ramus and a condylectomy with preservation of the LPM insertion was performed. This LPM insertion was isolated and a PDS 0 suture (Ethicon, Somerville, NJ, USA) was threaded through the tendon of the LPM. After fitting a dummy version of the fossa component and adapting the soft tissues if needed, the fossa component was fixed to the zygomatic arch with five screws between 5 and 13 mm in length. Next, the PDS suture was run through the condylar tunnel and the ramal component was positioned and fixated onto the mandibular stump using seven screws between 13 and 17 mm in length. Important to remark were the difficulties faced to properly attach the LPM onto the scaffold, due to an obstructive edge at the anteromedial side of the UHMWPE part of the fossa component. Consequently, all UHMWPE parts were scalpelreduced at their non-articulating anteromedial side. A multi-layer closure was then performed, after which a compressive bandage was applied. A more detailed description of the surgery protocol can be found in one of our earlier published papers (24).Euthanasia and implant retrievalTen months after surgery, after being kept in an indoor pen, all 14 sheep were euthanized. All sheep were then decapitated and the left half of the Nikolas de Meurechy NW.indd 138 05-06-2024 10:14