Experimental Study Of The Effect Of CFR-PEEK Prosthesis On Repair Of Temporomandibular Joint Defect In Rabbits

Carbon Fiber Reinforced Polyetheretherketone(CFR-PEEK)is a kind of improved reinforced implant material that has superior biomechanical properties comparing with polyetheretherketone(PEEK).It has a very close elastic modulus to human cortical bone and is promising material for orthopaedic implants.The temporal-mandibular joint(TMJ)is one of the most active joints in the human body and plays a crucial role in chewing,swallowing,breathing and pronunciating.Temporomandibular disorders(TMD)often lead to morphological defects and loss of function due to ankylosis,trauma,and tumors,which seriously affect the patient’s quality of life.The reconstruction of TMJ has always been a problem that plagues maxillofacial surgeons.Compared with other orthopedic materials,joint implant materials have special performance requirements:good biocompatibility and biosafety;sufficiently high mechanical properties and fatigue resistance;human cortical bones have a matching elastic modulus;biological inertia and good biological surface modification ability.In this paper,the feasibility and effect of reconstructing TMJ with joint prosthesis for CFR-PEEK were studied.In order to evaluate the feasibility of reconstructing TMJ with CFR-PEEK joint prosthesis,the TMJ joint prosthesis was made from CFR-PEEK material and its biological performance in animals was investigated through a series of biological experiments.Mouse osteoblast precursor MC3T3-E1 cells were used to study the cytotoxicity and alkaline phosphatase(ALP)activity of CFR-PEEK materials.The results showed that CFR-PEEK materials has biological safety and can be implanted into animals as joint replacementThe CFR-PEEK joint prosthesis in experimental animals were observed for 3months to elucidate the effect of reconstructing TMJ.Thirteen healthy Japanese white rabbits were randomly divided into three groups:(1)experimental group A,(2)experimental group B,and(3)control group C.In experiment group A,the right TMJarticular process of the rabbits were resected to establish the joint defect models,and then the CFR-PEEK prosthesis were impanted.In experimental group B,the right TMJ articular process of the rabbits were resected,and the joint defect models were established without the CFR-PEEK artificial joint implantion.The rabbits in control group didn’t received any treatment.During the ensuing 13 weeks,we conducted a series of experimental studies,such as measuring the body weight,computed tomography(CT)imaging examinations,magnetic resonance imaging(MRI)examinations,and micro-computed tomography(Micro-CT machine)examination,histology and histomorphology analysis,etc.Compared with group B,the weight of rabbits in experimental group A were significantly increased(P<0.05)after 13 weeks;Compared with control group,rabbits in group A had no significant change(P>0.05)after 13 weeks.The weight of rabbits in experimental group A and control group kept normal growth,the weights of rabbits in the experimental group B increased slowly,and even stopped growing.CT and MRI imaging examinations,as well as the implantation of CFR-PEEK artificial joint prosthesis after CT 3D reconstruction and in vitro visualization showed good retention instead of normal joints.The results of Micro-CT showed that after implantation of CFR-PEEK joint prosthesis for 13 weeks,part of the bone around the artificial prosthesis of the experimental group A was absorbed and there was osteoporosis;the surrounding bone tissue in the experimental group B was proliferated,but there was a great difference from the normal joint process like joint adhesion and ankylosis,without function.In the experiment,we obtained the viscera and implanted joints of the experimental rabbits and performed histological and histomorphometric analysis.The rabbits in the experimental group did not exhibit systemic toxicity.The heart,liver,pancreas,spleen,kidney,and lung were compared with the normal group without obvious difference;A experimental group implanted joints and surrounding bone tissue formed a good healing,local stress areas have bone resorption,no significant inflammatory reaction.In the experimental group B,pseudo-healing and adhesion of the surrounding bone tissue occurred after the removal of the right TMJ articular process.The results show that the CFR-PEEK material has excellent biological propertiesas TMJ implant material,and has good biological safety and activity.After implantation of the CFR-PEEK artificial joint,the bone tissue was well-healed,and the fixation was stable without looseness,which could replace the normal joint function.Compared with the experimental group B,the experimental group implanted with the CFR-PEEK prosthesis had a significantly better effect on repairing defects,which helps restore chewing function.Our results show that CFR-PEEK is very suitable as CFR-PEEK prosthesis and has excellent biomechanical properties.In short,CFR-PEEK is expected to be ideal material for rebuilding TMJ.