Craniofacial bone reconstruction with bioactive fiber-reinforced composite implant

Aitasalo, Kalle; Piitulainen, Jaakko M.; Rekola, Jami; Vallittu, Pekka K.

doi:10.1002/hed.23370

Cited by 78 publications

(46 citation statements)

References 43 publications

(48 reference statements)

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“…In addition, patient-specific titanium mesh can be manufactured via direct metal laser sintering to hold grafted bone in place and re-create contours and structures of the facial bone 67 . Bioglasses (such as S53P4, 6P53B, and 13–93) have been widely used in craniofacial surgery as a bone graft substitute due to their biocompatibility, strong mechanical strength, and osteoconductivity 1,27 . Bioglass structures can be manufactured by mixing glass particles into a solution, cold-printing in a layer-by-layer fashion, and then dehydrating at high temperatures to sinter the glass particles together and remove the solution 23,33 .…”

Section: 3d-printing For Surgical Reconstructionmentioning

confidence: 99%

3D-Printing Technologies for Craniofacial Rehabilitation, Reconstruction, and Regeneration

et al. 2016

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The treatment of craniofacial defects can present many challenges due to the variety of tissue-specific requirements and the complexity of anatomical structures in that region. 3D-printing technologies provide clinicians, engineers and scientists with the ability to create patient-specific solutions for craniofacial defects. Currently, there are 3 key strategies that utilize these technologies to restore both appearance and function to patients: rehabilitation, reconstruction and regeneration. In rehabilitation, 3D-printing can be used to create prostheses to replace or cover damaged tissues. Reconstruction, through plastic surgery, can also leverage 3D-printing technologies to create custom cutting guides, fixation devices, practice models and implanted medical devices to improve patient outcomes. Regeneration of tissue attempts to replace defects with biological materials. 3D-printing can be used to create either scaffolds or living, cellular constructs to signal tissue-forming cells to regenerate defect regions. By integrating these three approaches, 3D-printing technologies afford the opportunity to develop personalized treatment plans and design-driven manufacturing solutions to improve aesthetic and functional outcomes for patients with craniofacial defects.

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Section: 3d-printing For Surgical Reconstructionmentioning

confidence: 99%

3D-Printing Technologies for Craniofacial Rehabilitation, Reconstruction, and Regeneration

et al. 2016

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“…In addition to dentistry, the suitability of composite materials in maxillofacial implants has recently been studied. 11,13,18,19 Post-operative radiographic controls of all kinds of implants add valuable information, for example, for evaluation of possible bone resorption around the implant caused by inflammation or instability. CT or CBCT is often the preferred examination.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 In oral and cranial implantology, emphasis has been put on the development of non-metallic implants, such as implants made of composite materials. [10][11][12][13][14] Compared with metal implants, composite implants, especially fibre-reinforced composite (FRC) implants, are low weight and provide possibilities to tailor mechanical properties equal to those of the bone. [15][16][17] In addition, composite and FRC implants can be detected with CT and MRI.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of intensity of artefacts in CBCT by radio-opacity of composite simulation models of implantsin vitro

Kuusisto¹,

Vallittu²,

Lassila³

et al. 2015

Dentomaxillofacial Radiology

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Objectives:The aim was to compare the intensity of artefacts in CBCT images caused by different percentages of radio-opacifying material in composite simulation models of implants. Titanium and zirconia models of implants were used as a reference for the evaluation of the intensity of artefacts. Methods: Seven different percentages of radio-opacifying BaAlSiO 2 fillers were added to composite resin to fabricate seven step wedges and simulation models of implants. Titanium and zirconia simulation models of implants were also fabricated. Aluminium step wedge was used as a reference for the measurement of grey values in intraoral radiographs.Step wedges were exposed with a Planmeca Intra X-ray machine (Planmeca Oy, Helsinki, Finland). All composite, titanium and zirconia simulation models of implants were exposed with a SCANORA ® 3D dental X-ray machine (Soredex, Tuusula, Finland). Images and grey values were analysed with ImageJ software (National Institutes of Health, Bethesda, MD). To demonstrate possible artefacts between all the simulation models of implants, the images were also visually compared with each other using ImageJ software. Results: Artefacts were clearly present in CBCT images caused by titanium and zirconia and when the composite material consisted at least 20% BaAlSiO 2 . The intensity of artefacts increased when the radio-opacity of the composite material increased. Conclusions: Materials containing less radio-opacity produce less pronounced artefacts. The cut-off point for artefacts is at 20% radio-opaque filling material in composite material.

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“…To overcome discomfort and pain by cranial and facial bone reconstructions based on autologous bone transplants, and problems related to biomaterial implants, patient-specific FRC-BG cranial implants were started to be used first time in 2007 [23]. Before the time FRC-BG implants, the first-generation implants were made of bulk polymethylmethacrylate (PMMA) which has been polymerized ex vivo and covered from the surface with exposing particles of BG S53P4 [79].…”

Section: Clinical Use and Development Stages Of Frc-bg Implantsmentioning

confidence: 99%

“…The first approved surgical applications were found in cranial surgery [18]. To improve osteoconductivity and osteogenicity of the FRC material, particles of bioactive glass have been added to the surface of FRC implants or inside the implant [19][20][21][22][23]. Radiopacity of glass FRC corresponds to that of cortical bone, and therefore there are no artefacts in the diagnostic images, but the implant can be seen in the X-rays, CTs and MRIs (Fig.…”

Section: Introductionmentioning

confidence: 99%

Bioactive glass-containing cranial implants: an overview

Vallittu

2017

J Mater Sci

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Although metals have successfully been used as implants for decades, devices made out of metals do not meet all clinical requirements. For example, metal objects may interfere with some medical imaging systems (computer tomography, magnetic resonance imaging), while their stiffness also differs from natural bone and may cause stress-shielding and over-loading of bone. There has been a lot of development in the field of composite biomaterial research, which has focused to a large extent on biodegradable composites. This overview article reviews the rationale of using glass fiber-reinforced composite-bioactive glass (FRC-BG) in cranial implants. For this overview, published scientific articles with the search term ''bioactive glass cranial implant'' were collected for having basis to introduce a novel design of composite implant, which contains bioactive glass. Additional scientific information was based on articles in the fields of chemistry, engineering sciences and dentistry. Published articles of the material properties, biocompatibility and possibility to add bioactive glass to the FRC-BG implants alongside with the clinical experience as far suggest that there is a clinical need for bioactive nonmetallic implants. In the FRC-BG implants, biostable glass fibers are responsible for the load-bearing capacity of the implant, while the dissolution of the bioactive glass particles supports osteogenesis and vascularization and provides antimicrobial properties for the implant. Material combination of FRC-BG has been used clinically in cranioplasty and cranio-maxillo-facial implants, and they have been investigated also as oral and orthopedic implants. Material combination of FRC-BG has successfully been introduced to be a potential implant material in cranial surgery.

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Craniofacial bone reconstruction with bioactive fiber-reinforced composite implant

Abstract: The implants functioned appropriately, which would provide a potential solution for craniofacial bone reconstruction in the future.

Cited by 78 publications

References 43 publications

3D-Printing Technologies for Craniofacial Rehabilitation, Reconstruction, and Regeneration

3D-Printing Technologies for Craniofacial Rehabilitation, Reconstruction, and Regeneration

Evaluation of intensity of artefacts in CBCT by radio-opacity of composite simulation models of implantsin vitro

Bioactive glass-containing cranial implants: an overview

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