MORPHOLOGIC AND IMMUNOHISTOCHEMICAL OBSERVATION OF EXPLANTED PROPLAST-TEFLON TEMPOROMANDIBULAR-JOINT INTERPOSITIONAL IMPLANTS

Purpose: The objective of this study was to investigate the cellular t issue response to temporomandibular joint (TMJ) Proplast-Teflon disc m aterial by morphologic and immunohistochemical means. Patients and Met hods. Twelve patients who had been subjected to TMJ discectomy combine d with insertion of a Proplast-Teflon interpositional implant (PTIPI) were recalled for removal of the alloplastic disc. The time elapsed be tween the Proplast-Teflon disc implantation and its removal varied bet ween 13 and 71 months (mean, 54.6 +/- 5.8 [SEM]) The implants and peri implant tissues were examined by light microscopy and immunohistochemi cally using a panel of monoclonal antibodies reactive with different s ubclasses of leukocytes, The sections were immunostained using the alk aline phosphatase-antialkaline phosphatase (APAAP) technique. Results: Fibrosis and a massive foreign body giant cell reaction were seen ins ide the heavily disrupted alloplastic implants and in the periimplant tissues, CD68-positive monocyte-derived cells dominated the reactive i nfiltrate in the implants and surrounding tissue, The CD68-positive ce lls also were partly positive for lysozyme. The lymphocytic infiltrati on contained no B cells, Conclusions: This study of the PTIPI-induced tissue reaction gave no indication of a toxic or an immunologic pathog enesis. Mechanical stress seems important in the fragmentation of the implant and induction of the foreign body reaction. It is not yet know n if this fragmentation is the major contributing factor.