A new custom made bioceramic implant for the repair of large and complex craniofacial bone defects

2013 ◽  
Vol 41 (5) ◽  
pp. 403-407 ◽  
Author(s):  
Joël Brie ◽  
Thierry Chartier ◽  
Christophe Chaput ◽  
Cyrille Delage ◽  
Benjamin Pradeau ◽  
...  
Keyword(s):  
Bone Defects ◽  
Craniofacial Bone ◽  
Custom Made

Reconstruction of craniofacial bone defects with three-dimensional custom-made implants. A five year experience

2009 ◽  
Vol 38 (5) ◽  
pp. 500 ◽  
Author(s):  
H. Rotaru ◽  
G. Bǎciuţ ◽  
H. Stan ◽  
R. Schumacher ◽  
H.F. Zeilhofer ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Bone Defects ◽  
Craniofacial Bone ◽  
Custom Made

Workflow and Principles for Precisely Designing a Custom-Made Polyetheretherketone Implant Applied in Irregular Craniofacial Bone Defects

2021 ◽  
Vol 26 (3) ◽  
pp. 404-410
Author(s):  
Taoran Jiang ◽  
Zheyuan Yu ◽  
Jie Yuan ◽  
Liang Xu ◽  
Huichuang Duan ◽  
...  
Keyword(s):  
Bone Defects ◽  
Craniofacial Bone ◽  
Custom Made

scholarly journals Customized Polymethyl Methacrylate Implants for the Reconstruction of Craniofacial Osseous Defects

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
André Luis Fernandes da Silva ◽  
Alexandre Meireles Borba ◽  
Niverso Rodrigues Simão ◽  
Fábio Luis Miranda Pedro ◽  
Alvaro Henrique Borges ◽  
...  
Keyword(s):  
Polymethyl Methacrylate ◽  
Well Being ◽  
Bone Defects ◽  
Uneventful Recovery ◽  
Facial Skeleton ◽  
Aesthetic Result ◽  
Craniofacial Bone ◽  
Small Series ◽  
Custom Made ◽  
Craniofacial Defects

Craniofacial defects represent alterations in the anatomy and morphology of the cranial vault and the facial bones that potentially affect an individual’s psychological and social well-being. Although a variety of techniques and restorative procedures have been described for the reconstruction of the affected area, polymethyl methacrylate (PMMA), a biocompatible and nondegradable acrylic resin-based implant, is the most widely used alloplastic material for such craniomaxillofacial reconstruction. The aim of this study was to describe a technique for aesthetic and functional preoperative customized reconstruction of craniofacial bone defects from a small series of patients offered by the Brazilian public health system. Three adult male patients attended consultation with chief complaints directly related to their individual craniofacial bone defects. With the aid of multislice computed tomography scans and subsequent fabrication of the three-dimensional craniofacial prototype, custom-made PMMA implants were fabricated preoperatively. Under general anesthesia, with access to the craniofacial defects with a coronal approach, the PMMA implants were adapted and fixated to the facial skeleton with titanium plates and screws. Postoperative evaluation demonstrated uneventful recovery and an excellent aesthetic result. Customized prefabricated PMMA implants manufactured over the rapid prototyping models proved to be effective and feasible.

scholarly journals Early Outcomes of Patient-Specific Modular Cones for Substitution of Methaphysial and Diaphysial Bone Defects in Revision Knee Arthroplasty

2019 ◽  
Vol 25 (2) ◽  
pp. 9-18 ◽  
Author(s):  
A. A. Cherny ◽  
A. N. Kovalenko ◽  
S. S. Bilyk ◽  
A. O. Denisov ◽  
A. V. Kazemirskiy ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Scoring Systems ◽  
Bone Defects ◽  
Patient Specific ◽  
Implant Fixation ◽  
Diaphyseal Bone ◽  
Custom Made ◽  
The Stability ◽  
Valid Solution

The aim of this study was the assessment of early outcomes of patient-specific three-dimensional titanium cones with specified porosity parameters to compensate for extensive metaphysical-diaphyseal bone defects in RTKA.Materials and Methods. Since 2017 till 2019 30 patient-specific titanium cones (12 femoral and 18 tibial) implanted during 26 RTKAS. Clinical outcomes evaluated using KSS, WOMAC and fjS-12 scoring systems on average 10 (2–18) months after surgery. At the same time the stability of implant fixation analyzed using frontal, lateral and axial knee roentgenograms.Results. During all procedures there were no technical difficulties in positioning and implantation of custom-made titanium cones. At the time of preparation of the publication, none of the patients had indications for further surgical intervention, as well as intra- and postoperative complications. Six months after surgery all scores improved significantly: KSS from 23 (2–42, SD 19.96) to 66.5 (62–78, SD 7.68), WOMAC from 59 (56–96, SD 28.31) to 32.25 (19–46, SD 11.76), the index FJS-12 was 29.16 points (0–68.75, SD 30.19). The average scores continued to improve up to 18 months: KSS — 97.5 (88–108, SD 9.14), WOMAC — 16.5 (9–24, SD 6.45), FJS-12 — 45.85 (25–75, SD 22.03). No radiolucent lines were noticed during this period of observation.Conclusion. The original additive technology of designing and producing patient-specific titanium cones for compensation of extensive metaphyseal-diaphyseal bone defects in RTKA is a valid solution at least in the short term. A longer follow-up period is required to assess its medium-and long-term reliability compared to existing alternative surgical solutions.

scholarly journals Reconstruction of anterior frontal wall and contours defects using bone substitute

2021 ◽  
pp. 34
Author(s):  
Keyword(s):  
Bone Substitute ◽  
Calcium Sulfate ◽  
Donor Site ◽  
Bone Defects ◽  
Autogenous Bone ◽  
Bone Void Filler ◽  
Custom Made ◽  
Cranial Implant ◽  
Bone Void ◽  
Orbital Area

Aim: The aim of this article is to report on the safety and long-term efficacy of Cerament® BoneVoid Filler bone substitute for repairing craniofacial bone defects. Post-traumatic cranioplasty is a complex and challenging procedure for all maxillo-craniofacial surgeons and neurosurgeons, especially when repairing large areas. The standard criterion for repairing small cranial defects is the use autogenous bone from the iliac crest or split calvarial grafts. Autogenous grafts may result in donor-site morbidity, increased surgical time, reabsorption, blood loss, and longer recovery time . Alloplastic materials used for bone repair, such as methyl methacrylate, hydroxyapatite, titanium, or porous polyethylene, are expected to have optimal properties, including easy adaptation, biocompatibility, ingrowth of new tissue, stability of shape, and low rate of reabsorption. A cranial implant should be easily shaped and positioned, allowing easy tissue growth. In very wide cranium defects the new technology is a custom made cranial implant constructed three-dimensionally with different types of materials. However, this procedure is very expensive with various infection rates depending on the kind of material used and on the chemicophysical composition of the implant. Methods: The authors report the case of a 50-year-old man with a severe deformity of the forehead-supra orbital area as a result of a previous complex fronto-facial trauma treated in an emergency Unit. Secondary correction and reconstruction of the residual deformities were performed by using Cerament® Bone Void Filler, an alloplastic biphasic material, composed of 40% hydroxyapatite, 60% calcium sulfate and the radio-contrast agent iohexol. The unique ratio of hydroxyapatite and calcium sulfate is designed to enable Cerament to resorb at the same rate that bone forms. Calcium sulfate acts as a resorbable carrier for hydroxyapatite which is highly osteoconductive, promoting bone ingrowth.It seems to be a promising bone graft substitute in the management of bony irregularities in the fronto-orbital area. Conclusion: The patient was first hospitalized as the result of a serious craniofacial trauma. One year after the first emergency cranio-orbital reconstructive operation, a marked deformity of the frontal region appeared with a “grid effect” due to the inadequate plate-bony fixation of the fractures applied during the first bony recomposition and because it was not as rigid as it should have been . A secondary surgery for deformity correction was performed. The hardware was totally removed and the bony deformity smoothed, reshaped, covered and filled using Cerament® Bone Void Filler, a biomaterial. The patient recovered with a satisfactory cranium-forehead shape, no complications, and complete disappearance of a frowning look of the fronto-orbital region. Recently, increased use of bone substitutes in the reconstruction of bone defects has been fuelled by donor site complications associated with autologous bone harvesting. Cerament® BoneVoid Filler is a biphasic and injectable bone substitute that has a highly compressive strength and the ability to promote cancellous bone healing

scholarly journals 3D Biomimetic Porous Titanium (Ti6Al4V ELI) Scaffolds for Large Bone Critical Defect Reconstruction: An Experimental Study in Sheep

Animals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 1389 ◽  
Author(s):  
Alberto Maria Crovace ◽  
Luca Lacitignola ◽  
Donato Monopoli Forleo ◽  
Francesco Staffieri ◽  
Edda Francioso ◽  
...  
Keyword(s):  
Bone Defects ◽  
Porous Titanium ◽  
Control Group ◽  
Large Animal ◽  
Sintered Titanium ◽  
Porous Hydroxyapatite ◽  
X Ray ◽  
Custom Made ◽  
Critical Defect ◽  
Large Bone

The main goal in the treatment of large bone defects is to guarantee a rapid loading of the affected limb. In this paper, the authors proposed a new reconstructive technique that proved to be suitable to reach this purpose through the use of a custom-made biomimetic porous titanium scaffold. An in vivo study was undertaken where a complete critical defect was experimentally created in the diaphysis of the right tibia of twelve sheep and replaced with a five-centimeter porous scaffold of electron beam melting (EBM)-sintered titanium alloy (EBM group n = 6) or a porous hydroxyapatite scaffold (CONTROL group, n = 6). After surgery, the sheep were allowed to move freely in the barns. The outcome was monitored for up to 12 months by periodical X-ray and clinical examination. All animals in the CONTROL group were euthanized for humane reasons within the first month after surgery due to the onset of plate bending due to mechanical overload. Nine months after surgery, X-ray imaging showed the complete integration of the titanium implant in the tibia diaphysis and remodeling of the periosteal callus, with a well-defined cortical bone. At 12 months, sheep were euthanized, and the tibia were harvested and subjected to histological analysis. This showed bone tissue formations with bone trabeculae bridging titanium trabeculae, evidencing an optimal tissue-metal interaction. Our results show that EBM-sintered titanium devices, if used to repair critical bone defects in a large animal model, can guarantee immediate body weight-bearing, a rapid functional recovery, and a good osseointegration. The porous hydroxyapatite scaffolds proved to be not suitable in this model of large bone defect due to their known poor mechanical properties.

Reconstruction of craniofacial bone defects with individual alloplastic implants based on CAD/CAM-manipulated CT-data

1995 ◽  
Vol 23 (3) ◽  
pp. 175-181 ◽  
Author(s):  
H. Eufinger ◽  
M. Wehmöller ◽  
E. Machtens ◽  
L. Heuser ◽  
A. Harders ◽  
...  
Keyword(s):  
Bone Defects ◽  
Craniofacial Bone ◽  
Alloplastic Implants ◽  
Cad Cam ◽  
Ct Data

Clinical study of outcomes after revision surgery using porous titanium custom-made implants for severe acetabular septic bone defects

2020 ◽  
Vol 44 (10) ◽  
pp. 1957-1964
Author(s):  
Giorgio Burastero ◽  
Luca Cavagnaro ◽  
Francesco Chiarlone ◽  
Andrea Zanirato ◽  
Lorenzo Mosconi ◽  
...  
Keyword(s):  
Clinical Study ◽  
Revision Surgery ◽  
Bone Defects ◽  
Porous Titanium ◽  
Custom Made

LOCAL APPLICATION OF GROWTH HORMONE INDUCES INCREASED IMMUNOEXPRESSION OF IGF-I ON CRANIOFACIAL BONE DEFECTS REPAIR – A PILOT STUDY

2021 ◽  
pp. 31-35
Author(s):  
Felipe Rychuv Santos ◽  
Carmen L. Mueller Storrer ◽  
Suyany Gabriely Weiss ◽  
Leandro Kluppel ◽  
João César Zielak ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Bone Repair ◽  
Healing Process ◽  
Bone Defects ◽  
Local Effect ◽  
Control Group ◽  
Craniofacial Bone ◽  
Factor I ◽  
Collagen Group ◽  
Igf I

The aim is to evaluate the local effect of different concentrations of growth hormone (GH) on the repair of craniofacial bone defects, through histological, histomorfometric, and insulin-like growth factor I (IGF-I) immunoexpression assessments. Critical defects (5 mm) were performed in 32 Wistar rats. The animals were divided into four groups: Group C (Control); Group S (Sponge-collagen); Group GH 0.08 mL; GH 0.104 mg; Group GH 0.1mL. Local applications were performed 3 times a week until the rats were euthanized at 60 days. The data were submitted to ANOVA and Tukey's test (P < 0.05). A healing process with predominance of collagen bers and bone neoformation near the edges of the defect was observed in groups C and S. Islands of bone neoformation were observed at the center and edges of the defect in groups GH 0.08 and GH 0.1. In GH 0.1, the bone was more compact, and the defect was completely closed in some specimens. Bone neoformation was signicantly higher in the GH-treated groups. All the specimens stained positive for IGF-I, and this immunoexpression was signicantly higher in Group GH 0.1. In conclusion, locally applied GH signicantly favored bone repair in rat calvaria, and a higher dose of GH increased the immunoexpression of IGF-I.

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