Modular endoprosthesis for mandibular body reconstruction: a clinical, micro-CT and histologic evaluation in eight Macaca fascicularis.
This paper presents the results of an animal experiment, in which a modular endoprosthesis is tested to replace a resected part of the mandible. The prostheses were fixed with polymethacrylate (PMMA) cement into the medullar space of the stumps. Clinical, radiologic, micro-computed tomographic and histologic evaluations were made after 3 and 6 months on four Macaca fascicularis for each implantation time. The prosthesis had not loosened but there were some loose screws that had caused fistulas in three animals. The stems of the modules were stably fixed with PMMA cement, surrounded by a fibrous capsule with inflammatory cells. This capsule was thinner in the 6-month group and showed less inflammatory infiltrate compared with the 3-month group; this was not statistically significant. There was an increase in woven bone surrounding the modules after 6 months. After 3 months of implantation, there was a considerable inflammatory reaction in the soft tissues surrounding the module, which subsided over following 3 months. The results are encouraging, but a longer period of follow-up is required to assess its application in a clinical setting, and some design drawbacks need to be addressed.
Lee
S
S
Department of Oral & Maxillofacial Surgery, National Dental Centre, Singapore.
Goh
B T
BT
Tideman
H
H
Stoelinga
P J W
PJ
Jansen
J A
JA
D000497:Alloys; D000818:Animals; D001861:Bone Regeneration; D002484:Cementation; D003722:Dental Alloys; D005549:Foreign-Body Reaction / Q000209:etiology; D020007:Implants, Experimental; D008252:Macaca fascicularis; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008341:Mandibular Prosthesis / Q000009:adverse effects; D019930:Mandibular Prosthesis Implantation / Q000379:methods*; D016155:Oral Fistula / Q000209:etiology; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D019279:Resin Cements; D014025:Titanium; D055114:X-Ray Microtomography
D000497:Alloys; D003722:Dental Alloys; D019279:Resin Cements; C031462:titanium alloy (TiAl6V4); D014025:Titanium