Biological reconstruction of the mandibular condyle.

It is proposed in the scientific literature that the costochondral graft is the most suitable method for reconstruction of the mandibular condyle. Success is demonstrated by function and continued growth. Creeping substitution of osteoid does not compromise the osteochondral graft. In many species cartilage autografts survive and grow despite the absence of perichondrium and synovial membrane. These studies emphasise the importance of transferring only a thin cartilage cap on an osteochondral graft for optimum survival of cartilage cells. Many experiments involving metatarsals or ephiphyseal heads have failed to reproduce the cartilaginous cap found in the normal condyle. Despite evidence from animal studies, there is human experience of the unpredictability of costochondral grafts. Much remains to be evaluated, in animal model systems comparable with man, before optimum joint replacement can be assured in the treatment of those with congenital and acquired deformities of the condyle.