Page 20 - Demo

Chapter 118In the fifth chapter of this thesis the surface wear of both the condylar and fossa component are analyzed and discussed. Both a linear and volumetric wear analysis of the fossa was performed through optical scanning. The condylar surface was evaluated through scanning electron and confocal laser microscopy. The amount of wear between the two types of prosthetic systems was compared and the condylar surface smoothness was analyzed to determine the effect of the surface treatment. Lastly, the amount of wear that occurred was compared to the standards set in orthopedic surgery.Following the wear analysis of the prosthetic components, the next chapter discusses a histological analysis of the peri-articular tissues that was performed to evaluate the amount of inflammation in the peri-articular tissues. The inflammatory response between both types of prostheses was also compared. The tissues were evaluated for the presence of chronic inflammation as well as ‘synovial-like interface membrane’ type I synovitis and type VI reactions.Besides assuring suitability of implantation, based on wear properties, good osseointegration of the prosthetic system is needed as well. The last two chapters of the second part of this thesis discuss both the integration of the prosthetic system, as well as the integration of the reinserted LPM onto the condylar component. In chapter 7 a radiological analysis of the prosthetic system is performed, to first evaluate the integration of the LPM onto the condylar component. This led to the finding of four different radiological situations, based on which those sheep who showed (partial) bony integration were selected for further histological analysis in chapter 8, to determine if bony ingrowth within a scaffold at the condylar neck occurred. In both chapters the integration of the prosthetic components was also evaluated.Part 3 Clinical application and protocolsUsing the data and conclusions from the earlier chapters, the first chapter in the final part of this thesis discusses the development of the novel type of patient-specific, custom-made TMJ prosthesis, now applied for human implantation, using CAD-CAM, additive manufacturing and surface Nikolas de Meurechy NW.indd 18 05-06-2024 10:14