Craniofacial Reconstruction With High-Density Porous Polyethylene Implants

Abstract

Deformities of the facial skeleton may be reconstructed using autogenic or allogenic materials. Porous polyethylene is one of the few alloplastic materials currently in use having a well-documented history of reconstruction or augmentation in the maxillofacial region. High-density porous polyethylene, which is shown to be effective as a biomaterial, has additional advantages like tissue ingrowth, no capsule formation around it, and easy fixation. In this study, 83 implants in 71 patients were evaluated. Seven patients were in need of a second intervention. Three of the seven secondary interventions were for contour alignment, and four interventions were for extraction of the implants because of extrusion or infection. Placement of porous polyethylene implants directly under the skin without coverage of periosteum or another fascial envelope has an increased risk of early and especially late exposure. In cases like nasal dorsum or microtia reconstruction, we prefer autogenic grafts instead of allogenic materials.

Porous polyethylene implants in facial reconstruction: Outcome and complications

“…Craniofacial defects can be a result of trauma, malformations, or iatrogenic surgical defects. The zygoma and orbit are particularly vulnerable to injury due to their central position in the face (Eski et al, 2007;Menderes et al, 2004). Improper treatment of the zygomatico-orbital area results in loss of malar projection, enophthalmos, and dystopia (Eski et al, 2007).…”

“…Craniofacial reconstruction is performed by using onlay grafting with autogenous material or alloplastic implants (Eski et al, 2007;Menderes et al, 2004). The benefits of using autogenous material include relative resistance to infection, relative ease of incorporation into new bone, absence of a foreign body reaction, and a decreased incidence of extrusion (O'Connell et al, 2015).…”

History of synthetic materials in alloplastic cranioplasty

“…These features may have some degree of porous ingrowth. 3,25 Polyetheretherketone implants were originally developed for spinal surgery and hip replacement surgery in 1998. 17 These implants are also used in craniofacial reconstruction.…”

Reconstruction of the temporal contour for traumatic tissue loss using a CAD/CAM-prefabricated titanium implant-case report

“…by the injection of bone substitutes, silicone or implantation of fat or even by free tissue transfer. Acrylics, polyethylene (Menderes et al, 2004), bank cartilage (Sailer, 1976) or ceramics (Siebert et al, 2006) are alternative techniques using the visible contralateral side to check for symmetry. These methods are extremely dependent upon the skills of the surgeon.…”