BoneSource for Craniomaxillofacial Reconstruction

Abstract

Hydroxyapatite cement (HAC) is a calcium phosphate cement whose properties overcome the inherent limitations of previous forms of hydroxyapatite. HAC (BoneSource, Leibinger Corp., Dallas, TX) is prepared as a powder that forms an easily applicable paste which hardens in six to 20 minutes. HAC exhibits excellent biocompatibility, is easily contoured in situ, is highly stable, and allows osteoconduction. The use of calcium phosphate cements (CPC) for reconstruction of craniofacial defects has intrinsic appeal owing to the chemical and physical properties of hydroxyapatite. Difficulty in contouring CPC implants, their lack of compressive strength, and their failure to allow osteoinduction were significant limitations in the use of earlier forms of hydroxyapatite for skeletal reconstruction. HAC offers an excellent reconstructive option for repair of various craniofacial defects.

Histological and histomorphometric analyses of calcium phosphate cement in rabbit calvaria☆

“…They have also shown excellent retention of implanted volume, without any interference in the craniofacial growth for a period of approximately 3 years. Calcium phosphate cements show excellent biocompatibility, are easily mouldable in situ and allow osteoconduction (Turk and Parhiscar, 2000;Rupprecht et al, 2003).…”

Clinical Experience of the Brushite Calcium Phosphate Cement for the Repair and Augmentation of Surgically Induced Cranial Defects Following the Pterional Craniotomy

“…Two types of cements are distinguished depending on the end product of the setting reaction : apatite and brushite (DCPD or dicalcium phosphate dihydrate) cements, of which the latter recently raises great interest 16) . Brushite cements are resorbed faster than apatite cements [8][9][10][11][12][13][15][16][17][18][19][20] , but concerning the mechanical strength, brushite calcium phosphate cement is slightly weaker than apatite calcium phosphate cement 10) . However, in the non-weight bearing conditions of the skull, the difference between two cements may be irrelevant 10) .…”

“…The bone bonding effect of CPC makes it possible to have a great advantage of mold and adaptation to the individual defect with no need of special fixation elements. One of the first calcium phosphate cements, Bone Source has shown positive results when it is used in craniofacial reconstruction 4,17,18) . Bone Source shows excellent retention of implant volume, with no interference of craniofacial growth over a 3-year study period for the cases of pediatric patients 6) .…”

“…Calcium phosphate cement is highly biocompatible and is gradually replaced with autologous bone by osteoconduction 7) . Because of these characteristics, calcium phosphate cement has been used for the repair of craniofacial fractures in plastic and reconstructive surgeries 3,4,7,11,[17][18][19] . Calcium phosphate cements are composed of an aqueous solution and of one or several calcium phosphates.…”

“…Accompanying a negligible exothermic reaction, the CPCs provide structure integrity in hours. In addition, the minor exothermic nature of the CPC setting, together with the fact that no special fixation elements e.g., screws, miniplates or suture materials are needed to fix the CPC, makes this material ideal for craniofacial reconstruction 3,4,7,11,[17][18][19] . In this article, we report our clinical experience in repair and augmentation of bone defects to prevent postoperative temporal depression in several pterional craniotomy cases using a brushite CPC, PolyBone ® (Kyungwon Medical Co. Ltd., Seoul, Korea).…”