Autogenous auricular cartilage graft for temporomandibular joint repair: A comparison of technique with and without temporary silastic implantation

Abstract

Four Macaca fascicularis monkeys underwent bilateral temporomandibular joint surgery including disc removal, condyle recontouring and disc replacement using autogenous auricular cartilage grafts. One side was treated with the cartilage graft alone while the other side was treated with a cartilage graft combined with a temporarily implanted 0.02 inch dacron-reinforced silastic sheet. The silastic sheeting was removed at twelve weeks after the initial surgery. The monkeys were sacrificed at fourteen, twenty-four, thirty-six and fifty-two weeks after the initial disc removal and cartilage grafting. The joints treated with cartilage grafts alone showed significant fibrous connective tissue adhesions which had formed between the inferior surface of the graft and the articulating surface of the condyle. In the joints treated with a cartilage graft and silastic sheeting a joint space was clearly maintained between the cartilage graft and condylar surface without the formation of fibrous connective tissue adhesions. It appears that temporary implantation of a thin silastic sheet combined with autogenous cartilage grafting may prevent the formation of fibrous connective tissue adhesions within the joint.