Page 182 - Demo

Chapter 7180of the muscle onto the TMJR in three patients.(7) He proposed the use of a condylar lattice structure in the pterygoid fovea of the mandibular component of the TMJR to which the enthesis can be reattached. This structure is first filled with crushed autologous bone and concentrated bone marrow aspirate, to promote the formation of bone and collagenous tissue after reattachment of the LPM. Three patients were treated using this ‘reattachment’ technique. The study findings indicated that under the correct conditions, use of a condylar lattice structure resulted in a good outcome. With these findings serving as clinical proof of concept, we optimized this patient-specific TMJR and designed an animal model to further investigate the possibility of reconstruction of the lateral pterygoid muscle enthesis without addition of bone marrow aspirate as well as to evaluate overall TMJR performance. Materials and Methods In vivo test subjectsThere are biomechanical and morphological differences between the TMJ’s of different species. Therefore, compared with other species, some are more suitable for use as experimental animal models.(8) Primates such as monkeys are very similar to humans in both morphological and biomechanical TMJ characteristics, but their use is severely limited by ethics. While both sheep and goat TMJs show morphological similarities to the human TMJ, the total amount of daily mastication of goats is relatively limited compared with sheep. The latter spend an average of 4 hours per day eating at 128 mastication cycles per minute and 8 to 9 hours ruminating at 100 cycles per minute.(9) This high number of mastication cycles per day allows for reductions in the total period of in vivo evaluation, especially in terms of wear and overall performance (i.e., except for materials ageing), making them more suitable for this experiment. The total duration for the experiment was set at 288 days, which is equivalent to 22 years of human function. (10)Nikolas de Meurechy NW.indd 180 05-06-2024 10:14