Comparison of Biomaterials for Facial Bone Augmentation

Abstract

We compared the gross behavior of and microscopic response to implant materials currently in clinical use for facial bone augmentation at different sites in dogs. Materials evaluated include porous polytetrafluoroethylene carbon (Proplast), large-pore high-density polyethylene (Medpor), solid medical-grade silicone rubber (Silastic), polyamide mesh (Supramid), and autogenous rib bone. The subjects were 12 mixed-breed dogs and the materials were implanted directly on bone with periosteum removed at one of three sites in the dog's face (malar eminence, nasal dorsum, and chin). Animals were killed 3 months after surgery and stability of the implants was graded by manual manipulation. Blocks of tissue, including the study materials and underlying bone, were examined microscopically after sectioning. Stability results are tabulated and histologic appearance is described by site for each material evaluated. These data demonstrate marked variability of stability and cellular response depending on the site of implantation. From these data one may conclude that the site of implantation and implant movement are essential factors in determining the nature of the tissue response and fate of an implant. Solid and porous alloplastic materials show an acceptable tissue response, but neither demonstrates the ability to consistently provide an implant that is stable on underlying bone.

Long-term results following titanium cranioplasty of large skull defects

“…It is the principal component of bone, has the advantage of osteoconductivity, and allows osteointegration. 6,25 Despite high biocompatibility, inflammatory reactions have been described in numerous studies conducted in the early postoperative period and the few months after surgery. Thus, some authors have regarded HA as a contraindication for craniofacial reconstruction and pediatric populations in special settings.…”

Medpor Bone Implant Mimicking Postoperative Epidural Hematoma

“…Furthermore, graft resorption may also occur with autogenous implants. [11,12] Alloplastic implants are very useful for cranioplasty. Smooth-surfaced, solid implants include those made of silicone, methylmethacrylate, vitallium, silicone rubber, and titanium.…”

“…Porous materials include polytetrafluoroethylene, hydroxyapatite, and various mesh-type materials, such as polyamide mesh. [11,12] PHDPE can be used to repair cranial defects successfully, and complication rate is not high. As result of its open, porous character, it is well vascularized early, which is followed by soft tissue in-growth and collagen deposition.…”

“…No capsule formation occurs and it supports skin grafts. [11][12][13] Fibrovascularization of implant results in firm attachment to the surrounding tissue. Fibrovascularization is evidenced by CT and magnetic resonance imaging showing enhancement of PHDPE.…”

Estudo comparativo experimental de compósito bioativo de matriz polimérica para aplicação em cirurgia plástica ocular na substituição tecidual

“…Não houve diferença estatisticamente significativa na avaliação clínica dos grupos quanto à alteração de contorno e relevo das pálpebras no local dos implantes, ou a mobilidade e permanência dos implantes no nicho cirúrgico. Apesar de grande mobilidade da região palpebral, somente 26,8% dos implantes migrou totalmente do local do nicho cirúrgico, índi-ce menor que um estudo semelhante (20) , onde a migração ocorreu em 75% dos implantes. Esse fato pode ser atribuído à adequação do nicho cirúrgico, e, os compósitos, apresentarem camada de hidroxiapatita carbonatada (Figura 4).…”