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Chapter 8216Finally, although all condylar articulating surfaces were polished after printing, 6 of 13 condylar heads were resurfaced using a diamondlike carbon coating to increase surface hardness and reduce wear.(26) Application of the coating was achieved using the nondisclosed HadSat protocol with a Vickers hardness (HV0.05) of 3,500 ± 500 and a friction coefficient of 0.1. The biocompatibility of the coating was tested under the International Standard ISO 10993-1 by the North American Science Associates (Northwood, OH, USA). Fossa component The fossa component consisted of both a titanium and polyethylene component. The titanium component was additively manufactured from ELI Ti6Al4V and the as with the mandibular component, the bony interface was subjected to a SLA treatment to improve the bony ingrowth at the temporal fossa. Fixation was achieved using 5 titanium Gr 5, 2.0 mm diameter screws (Surgi-Tec NV, Ghent, Belgium) with lengths ranging from 5 to 13 mm, which were screwed into the zygomatic arch. At its condylar-facing side, a scaffold was designed, onto which a concave computer numeric controlled milled ɣ-radiated (100 kGy; Gammatom s.r.l. Como, Italy) Vitamin-E enriched highly-crosslinked ultra-high molecular weight polyethylene (HXLPE) component was hot pressed. The parameters for this process, such as pressure, temperature, and time, are proprietary information.Design adaptationAlthough the TMJR was to be implanted in sheep, the design was kept as close as possible to its human counterpart. Similar to the design and development for humans, a computed tomography (CT) scan was performed 6 weeks before the date of surgery. The CT data were provided in the Digital Imaging and Communications in Medicine (DICOM)-format to the engineers of CADskills BV (Ghent, Belgium), who processed the DICOM files into a standard template library (STL) file. Next, virtual resection of the left condyle was performed and a cutting guide was designed using Geomagic Freeform Plus (3D Systems, Rock Hill, SC, USA), allowing the surgeon to achieve the same ostectomy. Based on the performed ostectomy, an individual implant was then designed. The Nikolas de Meurechy NW.indd 216 05-06-2024 10:14