Long-Term Results following Cranial Hydroxyapatite Prosthesis Implantation in a Large Skull Defect Model

Martini, Lúcia; Staffa, Guido; Giavaresi, Gianluca; Salamanna, Francesca; Parrilli, Annapaola; Serchi, Elena; Pressato, Daniele; Arcangeli, E.; Fini, Milena

doi:10.1097/prs.0b013e318244220d

Cited by 43 publications

(24 citation statements)

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“…[47][48][49][50][51][52][53] To date, acceptable clinical results have been obtained but no suitable solutions have been found as yet for regenerating long and loadbearing bone segments: Indeed, the mechanical strength of a highly porous but ''disorganized'' scaffold is often insufficient in order to manage the in vivo stresses and physiological loadings. So far, the development of three-dimensional synthetic systems with hierarchical architecture have been limited by the currently available processing technology.…”

Section: Discussionmentioning

confidence: 99%

New Bio-ceramization process applied to vegetable hierarchical structures for bone regeneration: an experimental model in sheep.

Filardo

Kon

Tampieri

et al. 2013

Tissue Engineering Part A

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Bone loss is still a major problem in orthopedics. The purpose of this experimental study is to evaluate the safety and regenerative potential of a new scaffold based on a bio-ceramization process for bone regeneration in long diaphyseal defects in a sheep model. The scaffold was obtained by transformation of wood pieces into porous biomorphic silicon carbide (BioSiC Ò ). The process enabled the maintenance of the original wood microstructure, thus exhibiting hierarchically organized porosity and high mechanical strength. To improve cell adhesion and osseointegration, the external surface of the hollow cylinder was made more bioactive by electrodeposition of a uniform layer of collagen fibers that were mineralized with biomimetic hydroxyapatite, whereas the internal part was filled with a bio-hybrid HA/collagen composite. The final scaffold was then implanted in the metatarsus of 15 crossbred (Merinos-Sarda) adult sheep, divided into 3 groups: scaffold alone, scaffold with plateletrich plasma (PRP) augmentation, and scaffold with bone marrow stromal cells (BMSCs) added during implantation. Radiological analysis was performed at 4, 8, 12 weeks, and 4 months, when animals were sacrificed for the final radiological, histological, and histomorphometric evaluation. In all tested treatments, these analyses highlighted the presence of newly formed bone at the bone scaffolds' interface. Although a lack of substantial effect of PRP was demonstrated, the scaffold + BMSC augmentation showed the highest value of bone-to-implant contact and new bone growth inside the scaffold. The findings of this study suggest the potential of bio-ceramization processes applied to vegetable hierarchical structures for the production of woodderived bone scaffolds, and document a suitable augmentation procedure in enhancing bone regeneration, particularly when combined with BMSCs.

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Section: Discussionmentioning

confidence: 99%

New Bio-ceramization process applied to vegetable hierarchical structures for bone regeneration: an experimental model in sheep.

Filardo

Kon

Tampieri

et al. 2013

Tissue Engineering Part A

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“…Furthermore, the microstructure can be completely controlled. In particular, porous HAP implants that have been manufactured artificially and that have so-called open pore structures have excellent bone conduction and sufficient physical strength (Martini et al, 2012). For these reasons, they are already currently used in orthopedics, plastic surgery, neurosurgery, and dentistry (Byrd and Hobar, 1993;Ikenuma et al, 1988;Pompili et al, 1998;Rahn, 1989;Salyer and Hall, 1989).…”

Section: Introductionmentioning

confidence: 98%

Assessment of the RIVET fixation system for cranioplasty using the pull-out technique

Sakamoto

Minabe

Kato

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…Despite the advantages, hydroxyapatite use has been limited because of its brittle nature, low tensile strength, and high infection rates (Table 1). Hydroxyapatite has demonstrated osteointegration in animal models; 19,21,26 however, there is not much evidence for osteointegration for humans in vivo. 9 Frassanito et al demonstrated that hydroxyapatite may break down into many fragments over time in vivo, and they also demonstrated extremely limited osteointegration that lacked lamellar organization.…”

Section: Hydroxyapatitementioning

confidence: 99%

Materials used in cranioplasty: a history and analysis

Shah

Jung

Skirboll

2014

FOC

310

305

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Cranioplasty, one of the oldest surgical procedures used to repair cranial defects, has undergone many revolutions over time to find the ideal material to improve patient prognosis. Cranioplasty offers cosmetic and protective benefits for patients with cranial defects. The first primitive cranioplasty procedures date back to 7000 bc and used metal and gourds to repair cranial defects. Cranioplasty was first documented by Fallopius who described repair using gold plates; the first bone graft was documented by van Meekeren. The first significant improvement for this procedure began with experimentation involving bone grafts in the late 19th century as a more natural approach for repairing cranial defects. The next impetus for advancement came because of wartime injuries incurred during World Wars I and II and involved experimentation with synthetic materials to counter the common complications associated with bone grafts. Methyl methacrylate, hydroxyapatite, ceramics, and polyetheretherketone implants among other materials have since been researched and used. Research now has shifted toward molecular biology to improve the ability of the patient to regenerate bone using bone growth factors. This paper reviews the evolution of materials used over time in addition to the various advantages and pitfalls associated with each change. It is important for neurosurgeons to be mindful of how these techniques have evolved in order to gain a better understanding of this procedure and how it has been adapted.

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Long-Term Results following Cranial Hydroxyapatite Prosthesis Implantation in a Large Skull Defect Model

Abstract: The hydroxyapatite prosthesis showed its osteoconductivity and good biocompatibility. A low rate of fibrous tissue formation and a high rate of bony regeneration were found.

Cited by 43 publications

References 0 publications

New Bio-ceramization process applied to vegetable hierarchical structures for bone regeneration: an experimental model in sheep.

New Bio-ceramization process applied to vegetable hierarchical structures for bone regeneration: an experimental model in sheep.

Assessment of the RIVET fixation system for cranioplasty using the pull-out technique

Materials used in cranioplasty: a history and analysis

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