Page 219 - Demo

Animal experiment: Histological analysis of the LPM reattachment2178length and position of each screw was predetermined during the design of the implant, based on the amount of bone and adjacent anatomical structures, such as the inferior alveolar nerve. Additionally, 6 prostheses were randomly selected for additional HadSat-treatment of the condyle. Surgical protocolAn initial series of two sheep were treated to evaluate the surgical technique. One was treated using a TMJR, the other was subjected to sham surgery (the same surgical approach without condylectomy or prosthetic treatment). After further optimization of the surgical approach following these two sheep, 12 additional sheep were subjected to surgery using the established protocol. All the sheep were first pre-medicated using xylazine 0.1 mg/kg (Xyl M, V.M.D. nv, Arendonk, Belgium). Next, induction was achieved using ketamine 4 mg/kg (Nimatek; Dechra Pharmaceuticals PLC, Northwich, United Kingdom) and midazolam 0.2 mg/kg (Dormazolam; Le Vet Pharma BV, Oudewater, Netherlands), followed by orotracheal intubation. A mixture of O2-isoflurane was used to maintain anesthesia and intravenous administration of buprenorphine 6 µg/kg (Vetergesic; Ceva Santé Animale BV, Naaldwijk, Netherlands) was applied for an analgesic effect. Enrofloxacin 5 mg/kg (Floxadil; EMDOKA BVBA, Hoogstraten, Belgium) was administered both during surgery and for the first 5 post-operative days to prevent infection.After aseptic preparation (i.e., clipping, washing and disinfecting) and draping of the operative site, a 4-cm long mark was made over the posterior lower border of the mandible as well as a pre-auricular S-shaped mark inferior to the zygomatic arch. Local infiltration with xylocaine 1% containing 1/80,000 epinephrine (Dentsply Sirona, Charlotte, NC, USA) was administered to achieve local vasoconstriction and anesthesia, after which an incision through both marks was made. The masseter muscle was cut at the lower mandibular border, and subperiosteal elevation was achieved to allow insertion of the patient/prosthesis specific ELI-Ti cutting guide (CADskills BV, Ghent, Belgium) over the vertical ramus.Nikolas de Meurechy NW.indd 217 05-06-2024 10:14