Page 34 - Demo

Chapter 232Another milestone occurred in 1968, when the Silastic sponge (polysiloxane) was introduced to the field of prosthetic TMJ surgery by Robinson, as an alternative to stainless steel. While first being introduced as an interpositioning material in hand surgery, it quickly made its way into other prosthetic fields. (11,18) Despite Silastic’s relatively short life span in the world of implantology, it can be considered as one of the materials with the biggest impact on TMJ implantology. As well as Robinson, Morgan also made use of Silastic, albeit as an addition to his previously developed Vitallium prosthesis. When a degenerative condyle was present, the use of a Silastic® block was recommended to seat the Vitallium prosthesis more caudally to compensate for the diminished condylar height.(18,19)Two final important designs were the Vitek Teflon interpositional implant, first introduced in 1976(22), which will be discussed further on, and the Kriens(23) (OCEBM LOE IV) fossa prosthesis, which made use of Silastic® and was first used in 1973. This prosthesis was unique in that it abandoned the use of metallic parts altogether. It consisted of two Silastic strips that were implanted below the fossa and were then shaped by the pressure and movement of the condyle, which allowed for the prosthesis to achieve a well-adapted fit.(18,23)Table 2: Interpositional materials and fossa prosthesis.(6,12,13,15-19,21,24-26)Material Surgeon Year of introductionWood Carnochan 1840Gold Rosner 1889Gold-coated aluminum plate Orlow 1903Ivory Partsch 1932Gold foil Risdon 1934Metallic plate Ridson 1934Tantalum Eggers 1946Tantalum Goodsell 1947Stainless Steel Smith and Robinson 1957Stainless Steel Robinson 1960Co-Cr Christensen 1963Tantalum Hellinger 1964Co-Cr Morgan 1965Silastic® Robinson 1968Silastic® Kriens 1973Proplast-Teflon Vitek 1976Nikolas de Meurechy NW.indd 32 05-06-2024 10:14