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Light and electron microscopic evaluation of Proplast II TMJ disc implants
J D Valentine1, B E Reiman, E A Beuttenmuller
1Oral and Maxillofacial Surgery, Hays Army Hospital, Ford Ord, California, 93941.
Summary
Proplast II disc implants used in temporomandibular joint (TMJ) surgery showed significant deterioration, including fractures and microfragmentation, in all evaluated cases. These findings led to implant removal due to adverse patient outcomes.
Area of Science:
- Biomaterials science
- Oral and maxillofacial surgery
- Histopathology
Background:
- Proplast II implants were utilized for temporomandibular joint (TMJ) disc replacement.
- Patient outcomes and implant integrity following TMJ discectomy were evaluated.
Purpose of the Study:
- To assess the long-term performance and structural integrity of Proplast II implants after temporomandibular joint (TMJ) discectomy.
- To investigate the causes of implant failure and associated tissue reactions.
Main Methods:
- Analysis of retrieved Proplast II implants (n=14) and surrounding tissues from nine patients.
- Light and electron microscopy were employed to evaluate implant deterioration and tissue response.
- Clinical and radiographic data were reviewed for signs of pain, occlusal changes, or joint pathology.
Main Results:
- Gross deterioration, including fracture, was observed in 10 out of 14 implants.
- Microscopic deterioration was evident in all retrieved implants.
- A foreign-body giant cell reaction and microfragmentation were consistently found in the surrounding tissues.
Conclusions:
- Proplast II implants demonstrate significant material degradation and fragmentation following temporomandibular joint (TMJ) discectomy.
- Implant failure is associated with adverse clinical symptoms and histopathological tissue reactions.
- These findings raise concerns regarding the long-term suitability of Proplast II for TMJ reconstruction.