Page 216 - Demo

Chapter 8214with CADskills BV (Ghent, Belgium), that allowed for the reinsertion and reintegration of the LPM, onto the TMJR. The aim was to dissect the LPM and preserve all components of the muscle enthesis together with the condylar bony fragment onto which the muscle inserts itself. This (fibrous) enthesis consists of the muscle belly, the myotendinous junction (MTJ), the tendon and the bone-tendon junction (BTJ))(14,15). He aimed to reattach the both the enthesis and adjacent condylar bone to a scaffold in the condylar neck of the TMJR, to allow for LPM reconstruction and possible osseointegration. Following a promising human case series that served as a clinical proof of concept, an animal model was designed for further systematic investigation.(16) A first radiological analysis of the LPM reconstruction revealed a direct connection between the condylar scaffold and the LPM enthesis, be it either soft tissue, bony or a combination of the two, with close (less than 1mm) or direct approximation of the LPM’s bony enthesis against the condylar scaffold.(16) The aim of the current study was to further evaluate the histological aspects of the (osseous) integration of the enthesis into the TMJR scaffold, based on these radiological results, in a selected sample of five sheep. In two of these sheep, a fully bony connection was achieved, in three a partially soft tissue and bony connection was found.(16) Based on these results, we hypothesized that proper reinsertion had occurred in all five samples, at the level of the scaffold.Materials and Methods In vivo test subjectsAlthough several species of animals show similarities to the human TMJ and can be considered for experimental purposes, an animal model using sheep was selected for several reasons.(17) In addition to encountering fewer ethical concerns than those using of primates, sheep show significantly higher daily mastication activity than goats, allowing reduction of the total experiment duration.(18) The experiment duration was set at 288 days, equaling 22 years of human function.(19) Nikolas de Meurechy NW.indd 214 05-06-2024 10:14