Bioactive Glass-Ceramics in Facial Skeleton Contouring

Abstract

The removal of certain facial-bone defects is a prerequisite to restoration of function, stability, and appearance. Synthetic bone substitutes are beneficial in cases where other operative techniques would be an unacceptable burden for a patient. Satisfactory results can be achieved in one surgical intervention with low costs and low demand on technical equipment. Osteoconductive, biocompatible, non-resorbable glass-ceramic implants based on oxyfluoroapatite and wollastonite permit osteointegration--a direct physical and chemical bond between live bone tissue and the implant without formation of a fibrous capsule. They display better stress durability in simulated body fluid than hydroxyapatite implants do. This material was used for facial skeletal framework, contour restoration in 44 cases under conditions where other solutions were doubtful. Patients were observed for 24.8 months. Immediate healing occurred without any adverse reaction. The main problem was extrusion, observed in 20.45% cases over a 2-3 month period after the implantation. All cases, with one exception, were solved with a satisfactory final result by reoperation, implant size reduction, and increased soft tissue cover. This approach was found to be a suitable technique, especially for patients exhausted by prior incompetent treatment but still dissatisfied with their appearance. Successful reconstruction with a bone substitute may remarkably increase quality of life for affected persons and, at the same time, reduce surgery-related time and costs.

Scar Flap for Extension of the Nasal and Lip Soft Tissue Shell in Secondary Cleft Deformities

“…These can be taken care of along with the correction of the nose and lip. 9 All principles outlined above were respected in the study group. An upper age limit of corrective intervention was deliberately not set.…”

“…1,9,10 Naturally, the demand for hard tissues to support the resulting contour needs to be considered. Autologous grafts are viewed as suitable substitutes for bone and cartilage.…”

Bone Reconstruction of the Maxillary Alveolus for Subsequent Insertion of a Dental Implant in Patients With Cleft Lip and Palate

“…14 Patients demand maximum effect with minimum risk, negligible needed time, and low financial costs. 15 Especially patients in older age groups have a negative attitude toward complex procedures. 16 Patient selection for the reconstruction of the alveolus with the subsequent application of a dental implant must be very rigorous.…”

Biomaterials for craniofacial reconstruction

“…Duskova et al [46] reported an extrusion rate of 20% over a time period of 2 years for glass ceramic implants used in facial recontouring. Despite the authors’ positive resumee this complication rate seems too high.…”