Norian Craniofacial Repair System: Compatibility with Resorbable and Nonresorbable Plating Materials (original) (raw)
Related papers
Journal of maxillofacial and oral surgery, 2015
Cranial defects may arise due to trauma, infection, surgical ablation or errors in development. Restoration of such defects is important for esthetics, function and morale of the patient. Several materials are available. Each has its advantages and disadvantages. Search is on for an ideal material. Autogenous grafts remain the gold standard in reconstruction of such defects. However, the morbidity associated with their harvest, additional time required, the need for a second surgical site and the limited supply has led to the search for newer substitutes. Although many materials are available today including biologic and non biologic substitutes, there is still no consensus about the best material. In this article we describe our use of calcium phosphate cements for reconstruction of hemispherical cranial defects. Cases requiring reconstruction of hemispherical cranial defects (more than 15 cm in any dimension) were selected for study. After exposing the defect under GA, titanium me...
Journal of Biomedical Materials Research Part A, 2006
Calcium phosphate (Ca-P) cement is a well established material for bone repair. The bone biological properties of Ca-P cement can even be further improved by creating porosity in the material. The current study aimed on the evaluation of the osteoconductive behavior of porous Ca-P cement. Therefore, circular defects (6, 9, and 15 mm in diameter) were created in the cranium of 3 months old rabbits and filled with porous Ca-P cement implants. The total porosity of implants was calculated to be 71, 74 and 74% respectively and the average pore diameter was 150 lm. In addition, empty control defects were prepared. After 12 weeks implantation time the animals were sacrificed and radiographic, histological, and histomorphometrical evaluation was performed. The Critical Size Defect (CSD) of this species at this location for an implantation time of 12 weeks was confirmed to be 15 mm.
Use of a calcium phosphate matrix as a temporary cast for bony defect repair: a pilot study
Journal of Materials Science - J MATER SCI, 2003
The bony repair effect of different Calcium Phosphate Bone Cements was tested in a dog model. Seven different formulations were synthesized and tested on their biocompatibility, osseoconduction and biodegradability. Three dogs were used in this pilot study, in each dog 4 cranial, circular defects were made with a critical size diameter of 12 mm. Autologous bone was used as a control. The dogs were sacrificed after 6 months. Mineral phase analysis showed a reaction of the cements to form a more or less crystalline calciumhydroxyapatite. Histologic evaluation revealed that the presence of the cements stimulated the formation of a thin bone layer on the cranial and caudal side of each defect. The cements did not evoke an inflammatory reaction. Two formulations showed extensive bone formation.
Repair of craniofacial defects with hydroxyapatite cement
Journal of oral and maxillofacial …, 1997
Purpose: The objective of this study was to evaluate the course of healing of craniofacial bone defects when filled with hydroxyapatite cement and to determine whether adding various percentages by weight of demineralized bone powder to the cement will result in ...
Journal of Research of the National Institute of Standards and Technology, 2001
Research on calcium phosphate chemistry at NIST led to the discovery of the worlds first self-hardening calcium phosphate cements (CPC) in 1987. Laboratory, animal, and clinical studies were conducted to develop CPC into clinically useful biomaterials. The combination of self-hardening capability and high biocompatibility makes CPC a unique material for repairing bone defects. Near perfect adaptation of the cement to the tissue surfaces in a defect, and a gradual resorption followed by new bone formation are some of the other distinctive advantages of this biomaterial. In 1996 a CPC, consisting of tetracalcium phosphate and dicalcium phosphate anhydrous, was approved by the Food and Drug Administration (FDA) for repairing cranial defects in humans, thus becoming the first material of its kind available for clinical use. This paper will review the course of the development, the physical and chemical properties, and clinical applications of CPC.
Journal of Cranio-Maxillofacial Surgery, 2005
Introduction: Aim of this experimental study was to assess the suitability of a new brushite calcium phosphate cement (chronOStInject) for cranioplasty and to compare the results with a commercially available apatite calcium phosphate bone cement (Biobon s ). Material and methods: A bilateral full-size craniotomy defect (23 mm in diameter) was created in the parietal bones of 18 adult Swiss Alpine sheep and filled with either chronOStInject or Biobon s . The observation intervals were 2, 4 and 6 months. Macroscopical, radiological, histological and histomorphometrical evaluations were performed. Results: New bone formation was moderate and did not differ significantly between the biomaterials. Cement resorption occurred centripetally in the chronOStInject group and proceeded significantly faster than the degradation process of Biobon s . However, implantation of chronOStInject was associated with a significantly higher rate of fibrous tissue formation. Cement resorption was mediated by macrophages in the chronOStInject group, while osteoclasts were the predominant cell type involved in degradation of Biobon s . Osteoblasts were found adjacent to residual cement in both groups. Conclusion: chronOStInject demonstrated osteoconductive properties, good biocompatibility and superior bioresorbability but none of the cements proved suitable for filling large cranial bony defects due to the high rate of fibrous tissue formation and insufficient bony regeneration. r 2004 European Association for Cranio-Maxillofacial Surgery
Critical Defect Healing Assessment in Rat Calvaria Filled with Injectable Calcium Phosphate Cement
Journal of Functional Biomaterials, 2019
(1) Background: The tissue engineering field has been working to find biomaterials that mimic the biological properties of autogenous bone grafts. (2) Aim: To evaluate the osteoconduction potential of injectable calcium phosphate cement implanted in critical defects in rat calvaria. (3) Methods: In the calvarial bone of 36 rats, 7-mm diameter critical size defects were performed. Afterwards, the animals were randomly divided into three groups according to filler material: a blood clot group (BC), blood clot membrane group (BCM), and an injectable β-tricalcium phosphate group (HBS) cement group. After periods of 30 and 60 days, the animals were euthanized, the calvaria was isolated, and submitted to a decalcification process for later blades confection. Qualitative and quantitative analysis of the neoformed bone tissue were conducted, and histometric data were statistically analyzed. (4) Results: Sixty days post-surgery, the percentages of neoformed bone were 10.67 ± 5.57 in group BC, 16.71 ± 5.0 in group BCM, and 55.11 ± 13.20 in group HBS. The bone formation values in group HBS were significantly higher (p < 0.05) than in groups BC and BCM. (5) Conclusions: Based on these results, it can be concluded that injectable calcium phosphate cement is an osteoconductive material that can be used to fill bone cavities.
Use of Calcium-Based Bone Cements in the Repair of Large, Full-Thickness Cranial Defects: A Caution
Plastic and Reconstructive Surgery, 2007
Background: Calcium-based bone cements have increased in popularity for the correction of craniofacial contour defects. The authors' experience with them in more than 120 patients has resulted in the establishment of strict criteria for their use. Although the authors' overall complication rate with these cements has been low, certain patient groups have an unacceptably high complication rate. The authors describe their experience with the repair of large, full-thickness cranial defects using calcium-based bone cements. Methods: The study group comprised 16 patients who underwent correction of large, full-thickness (Ͼ25 cm 2) skull defects. The surgical technique included reconstruction of the floor of the defect with rigid fixation to the surrounding native bone, interposition of the cement to ideal contour, and closure of the defect. Results: The mean patient age was 35 years (range, 1 to 69 years). The mean defect area was 66.4 cm 2 (range, 30 to 150 cm 2). Cases were equally divided between BoneSource and Norian CRS. The mean amount of bone cement used was 80 g. Follow-up varied between 1 and 6 years (mean, 3 years). Major complications occurred in eight of 16 patients, with one occurring as late as 6 years postoperatively. Complications occurred throughout the course of review, indicating that they were not caused by a learning curve. Conclusion: Because of the unacceptably high complication rate with the use of calcium-based bone cements in large skull defects, the authors believe that their use is contraindicated and have returned to using autogenous split skull cranial bone reconstruction for these patients.