@article{f11f8504b6c942de9e4c0b3c3ab25b9a,
title = "Preserving the posterior superior synovial recess during allograft TMJ diskal condylar transplantation in the adult goat",
abstract = "Objective. The purpose of the study was to test the hypothesis that sparing the posterior superior synovial recess during the resection of temporomandibular joint condyle and disk would maintain a critical mass of synovium necessary to predictably achieve a successful allograft joint reconstruction. Study design. A group of 15 adult goats underwent unilateral resection of their temporomandibular condyle and meniscus. The fossa and posterior superior synovial recess were left intact. They were immediately reconstructed with cryogenically preserved allograft mandibular condyles and temporomandibular joint disk harvested from 15 adult donor goats. The animals were evaluated clinically and radiographically at 6 and 12 months and histologically at 12 months. Results. Of the 15 animals, 13 met all the criteria to be declared a success and retained the posterior superior synovial recess. Conclusion. Immediate joint reconstruction using cryogenically preserved mandibular condyles and temporomandibular joint disk can have a high rate of success if the native posterior superior synovial recess remains intact.",
author = "Bifano, {Carl A.} and Hubbard, {Gene B.} and Bifano, {Sandra L.}",
note = "Funding Information: In our previous articles, 1-3 we showed that it was feasible to biologically reconstruct the temporomandibular joint (TMJ) using cryogenically preserved transplants. Our previous studies involved using cryogenically preserved allograft mandibular condyles for hemiarticular TMJ reconstruction and allograft mandibular condyles, TMJ disks, and fossa for total TMJ reconstruction in adult and juvenile mixed breed goats. 1-3 The degree of success was significantly different when we advanced from hemiarticular to total joint reconstruction. In these studies the following criteria were required to declare a joint reconstruction successful: (1) The reconstructed joint must be capable of a clinically normal range of motion, (2) the superior joint space must be intact on arthrographic examination, (3) the transplanted articular surfaces must be intact histologically, (4) the superior joint space must be intact and relatively free of fibrosis with functional synovial tissue, and (5) the graft system must have supported nor-real growth, with the mature mandible having a midline deviation of less than 3 ram. The hemiarticular recon- The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or other Departments of the United States Government. aChief of Research, Department of Oral/Maxillofacial Surgery, Wilford Hall Medical Center, Lacldand Air Force Base. bVeterinary Pathologist, Southwest Foundation for Biomedical Research. cChief of Research Design, Clinical Investigation Division, Wilford Hall Medical Center, Lackland Air Force Base. Received for publication Feb. 11, 1997; returned for revision April 1, 1997; accepted for publication June 23, 1997. Copyright {\textcopyright} 1997 by Mosby-Year Book, Inc. 1079-2104/97/$5.00 + 0 7/12/84596 structions achieved these criteria with a success rate of 87%; the total joint reconstructions had a lower success rate of 50%. The reason for failure in all groups included fibrosis of the superior joint space, absence of functional synovium, and partial or complete loss of the articular surface. Active inflammation, acute or chronic, was not observed to be a factor in these failures. Most of the failed adult total joint reconstructed animals had successful reconstruction of the majority of the bone portion of the condyle and fossa.",
year = "1997",
doi = "10.1016/S1079-2104(97)90262-6",
language = "English (US)",
volume = "84",
pages = "483--487",
journal = "Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology",
issn = "2212-4403",
publisher = "Elsevier USA",
number = "5",
}