Replacement of the condyle and ascending ramus by a modular endoprosthesis in Macaca fascicularis-part 2: microcomputed tomographic and histologic evaluation of the ramus and stem

J Oral Maxillofac Surg. 2009 Dec;67(12):2617-26. doi: 10.1016/j.joms.2009.04.073.

Abstract

Purpose: The present study presents the microcomputed tomographic and histologic evaluation of the peri-implant tissues of a modular endoprosthesis used to replace the condyle and ascending ramus in Macaca fascicularis.

Materials and methods: The right condyle and ascending ramus were resected in 8 adult monkeys and replaced by a modular endoprosthesis, fixed with polymethylmethacrylate bone cement (Palacos). Four monkeys were sacrificed at 3 months and 4 at 6 months postoperatively. Microcomputed tomographic scanning was performed to analyze the bone volume at the bone-cement interface. Histologic and histomorphometric assessments were done using a modified hard and soft tissue grading scale and by studying the total bone contact at the interface.

Results: The combined (buccal, lingual, and inferior) mean bone volume percentage of the 6-month group was significantly greater than that of the 3-month group (P < .05). The 6-month specimens showed a reduced inflammatory response and more abundant bone formation around the stem. The total soft tissue histologic score was significantly greater in the 6-month group (P < .05). A total bone contact percentage of 15.4% to 85.2% was achieved in 3 specimens.

Conclusions: Satisfactory bone growth was found at the bone-cement interface at the stem region, although direct bone contact with the cement was not achieved in all cases. Soft tissue contact with the prosthetic ramus, in the form of a fibrous capsule, was present in some areas. At 6 months, minimal interfacial inflammation was found in this monkey model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Foreign-Body Reaction / pathology
  • Inflammation / pathology
  • Macaca fascicularis
  • Male
  • Mandible / diagnostic imaging
  • Mandible / pathology
  • Mandible / surgery*
  • Mandibular Condyle / surgery
  • Mandibular Prosthesis*
  • Methylmethacrylate
  • Osteogenesis
  • Prosthesis Design
  • X-Ray Microtomography*

Substances

  • Methylmethacrylate