Page 231 - Demo

Animal experiment: Histological analysis of the LPM reattachment2298contribute to better osteointegration. While part of the resected bone was ground down and applied into the scaffold, providing a local high concentration of osseoinductive cells, no local MSC’s were added to the construct, thus limiting the osteogenic properties. The occurrence of heterotopic ossification adjacent to the ramal component of the implant, where the periosteum was retained,(16) seems to further support the importance of the presence of mesenchymal cells. This limitation at the scaffold site could be overcome through the use of either mesenchymal stem cells or bone marrow aspirate (BMA), preferably combined with β-tricalcium phosphate (β-TCP), as proven by Spalthoff et al.(41,42) Fig. 7: Detailed view of osseous ingrowth of the mandibular ramus into the implant scaffold Red arro Titanium scaffold. Black arro Ramal cortical bone Green arro Haversian canals Blue arro Vascular lumen with bloodBesides providing a suitable environment for osseous healing to occur, direct contact between the implant and the bony tissue is needed for contact repair to occur. This direct contact between the scaffold and the bony fragment allows for osteoprogenitor cells to be derived directly from the Haversian canals. (43,44) While there were no significant difficulties to properly dissect and fixate the bony condylar segment in the patients treated by Mommaerts(13), this was less so the case for the operated sheep. Both difficult dissection and ostectomy due to anatomical differences compared to its human counterpart, as well as difficulties with proper fixation onto the scaffold, were significant Nikolas de Meurechy NW.indd 229 05-06-2024 10:14