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Chapter 8224analyzed enthesis and was most apparent near the implant scaffold site. (Fig. 5) Despite this bone remodeling, no or very limited ingrowth into the scaffold was seen. Important to notice is that in all 5 samples, the enthesis evaluated was considerably larger in width and length compared to the intraoperatively dissected bony enthesis, suggesting active growth of the bony enthesis, mainly in anteromedial direction. Furthermore, in 2 samples some heterotopic ossification was found surrounding the implant. Lastly, in all samples a dense well-organized layer of collagenous tissue was present anteromedially of the enthesis, transitioning into muscle fibers of the LPM. (Fig. 6)Besides these general findings, a 1190µm thick cartilaginous structure was identified in one sample. This cartilage was located near the anterior edge of the implant and was flanked by an osseous structure, suggesting a possible incomplete resection of the articular disc. The LPM tendon was found inserting onto this cartilaginous tissue as well. Important to remark is that in one sample, following to tissue loss occurring during the cutting and grinding of the sample, part of the implant became dislodged out of the Technovit 9100 block. As such it was no longer possible to obtain sections at a similar height to the other samples, resulting in a section that is several millimeters below the preferred section height. As a result, the opening of the scaffold towards the bony enthesis is not included in the sample. Ramal integrationBoth samples showed good osseointegration of the ramal component onto the mandible, with bone having formed in between the nontranslucent scaffolds (Fig. 7). One sample partially contained two Ti screws, with bone surrounding the screw threads. In one sample a layer of storiformly organized connective tissue was observed near the anterior border of the ramal component. At the anterior border, the connective tissue becomes a 320-580µm thick lamellar layer reverting to the exterior side. This layer of connective tissue was likely due to improper anteroposterior positioning of the implant. In the second sample, a layer of storiformly organized collagen is seen at the rear edge of the implant, Nikolas de Meurechy NW.indd 224 05-06-2024 10:14