Page 47 - Demo

Historical evolution of the TMJ prosthesis452around the implant, Braley63 failed to mention that Brown et al.64 explanted the discs at the end of their experiment. Silastic was first used for hand surgery in 1968 but was quickly adopted by maxillofacial surgeons. Robinson added a layer of Silastic to his fossa prosthesis in the same year, where it served as interpositioning material between the surface of the prosthesis and the bony fossa.(18) Morgan et al.(18) used Silastic to line the fossa prosthesis in cases of a degenerated condyle, while Kriens et al.(23) went one step further and removed the metal fossa, exchanging it for several layers of Silastic, which were then shaped by the pressure of the condylar component of the prosthesis. While short-term results were very promising, positive reports of longterm results without complications were initially lacking. Mercuri stated that this could have been due to a reluctance to report, but by 1982 reports of the fragmentation of the material and FBGCR in humans and animals became more frequent, and the long-term instability of the material became clear.(74) Small Silastic particles were found in lymph nodes near the implant site, and severe reactive synovitis was reported.(71,74) In 1992, Eriksson et al.(75) compared patients who underwent a discectomy with patients who received a Silastic implant and concluded that all patients who showed less favorable results had received a Silastic implant. Mercuri and Giobbie-Hurder concluded that patients who were previously exposed to Silastic showed poorer long-term outcomes after alloplastic reconstruction compared with patients who had not come into contact with the material.(74) This resulted in the AAOMS advising against further use of the material in 1993, leading to a halt in the production of Silastic.(76) PolytetrafluoroethyleneFirst developed in 1938, PTFE found its way into medical applications after Cook reported on its successful use as an interpositional material with an absence of inflammatory reaction in two animal studies and four human cases, which were followed for a period of 18 months.(77) Opposing these findings were studies conducted by Charnley(22,78) and Scales and Stinson(79), who noticed fragmentation of Teflon leading to FBGCR when the material was used in a hip prosthesis. Cook, however, Nikolas de Meurechy NW.indd 45 05-06-2024 10:14