J-U Piesold1, M Merwald, K Braxein, H Pistner. 1. Klinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, HELIOS-Klinikum Erfurt. jpiesold@erfurt.helios-kliniken.de
Abstract
BACKGROUND: Long-term results using hydroxyapatite cement (Bone Source) for the reconstruction of the facial skeleton and the forehead are reported. MATERIAL AND METHODS: The cement consists of 73% tetracalcium phosphate and 27% dicalcium phosphate. Using 0.25 M phosphoric acid instead of water, the primary setting time can be shortened from 20 to 5 min in an isothermic reaction. Twenty-two patients suffering from consequences of trauma, tumor-like lesions, or neoplasm as well as dysmorphia were treated. RESULTS: Following implantation, the healing process proceeded in most cases without complications. Due to hematoma and seroma as well as infection, two implants were lost. Follow-up examinations could be performed in 19 of the 22 patients on a average 40 months after operation. Most patients had good clinical long-term results. X-ray-analysis showed some discrete resorption of the implants in six patients. The further course must be decided based on clinical relevance. DISCUSSION: The hydroxyapatite cement used in this study evidenced good intraoperative handling, an excellent histologically proved biocompatibility, and good long-term stability in normal body fluid. Up to now we have limited its use to non-load-bearing applications in craniofacial surgery.
BACKGROUND: Long-term results using hydroxyapatite cement (Bone Source) for the reconstruction of the facial skeleton and the forehead are reported. MATERIAL AND METHODS: The cement consists of 73% tetracalcium phosphate and 27% dicalcium phosphate. Using 0.25 M phosphoric acid instead of water, the primary setting time can be shortened from 20 to 5 min in an isothermic reaction. Twenty-two patients suffering from consequences of trauma, tumor-like lesions, or neoplasm as well as dysmorphia were treated. RESULTS: Following implantation, the healing process proceeded in most cases without complications. Due to hematoma and seroma as well as infection, two implants were lost. Follow-up examinations could be performed in 19 of the 22 patients on a average 40 months after operation. Most patients had good clinical long-term results. X-ray-analysis showed some discrete resorption of the implants in six patients. The further course must be decided based on clinical relevance. DISCUSSION: The hydroxyapatite cement used in this study evidenced good intraoperative handling, an excellent histologically proved biocompatibility, and good long-term stability in normal body fluid. Up to now we have limited its use to non-load-bearing applications in craniofacial surgery.
Authors: Thiago Calcagnotto; Marcos Miguel Bechstedt Schwengber; Carlos Cesar De Antoni; Danilo Louzada de Oliveira; Théssio Mina Vago; Jessica Guilinelli Journal: Ann Maxillofac Surg Date: 2017 Jan-Jun