Norian Craniofacial Repair System: Compatibility with Resorbable and Nonresorbable Plating Materials

Abstract

There are no long-term adverse effects with the use of Norian cement with either titanium or resorbable mesh. However, further studies need to be conducted to determine why there is an arrested healing phase between 3 and 6 months with the Norian cement and resorbable plating materials.

A Novel Application of Calcium Phosphate-Based Bone Cement as an Adjunct Procedure in Adult Craniofacial Reconstruction

“…Wound infection was suggested to be higher when Norian CRS was used in conjunction with largescale osteotomies in one study, although the authors noted that it may well be due to the scale of the surgery rather than the use of the bone cement. 8 We have not noticed any increased rates of wound infection in our short follow-up so far.…”

“…Histologically, there was evidence of invasion of the calcium phosphate by bone, which peaked at 6 months. 8 Norian CRS has also been used successfully in several studies for the reconstruction of small to moderate-sized craniofacial defects, particularly in the pediatric population, with good evidence of bony ingrowth into the bone cement and relatively little resorption of the cement in long-term follow-up. 2,9 This follows the previous widespread use of calcium hydroxyapatite cement for the secondary reconstruction of craniofacial defects, particularly orbitocranial reconstruction.…”

Bone Grafts in Craniofacial Surgery

“…Additionally, there might be some interaction between certain bone graft materials, such as DBM or hydroxyapatite cements and some resorbable materials, such as Lactosorb 1 (Walter Lorenz Surgical, Inc., Jacksonville, FL). 75,105 FUTURE DIRECTIONS Autogenous bone grafts remain the gold standard for surgical reconstruction of bone defects. However, advances in tissue engineering and biomaterials technology will provide more tools for these procedures.…”

Biomaterials for craniofacial reconstruction

“…Other cement types (Norian SRS ® , Synthes) consist of modified components (mono calcium phosphate) and therefore show different curing times, physical and resorption characteristics etc. [59], [168], [134] (also see chapter 3.3.2.2, presentation Maier http://www.egms.de/en/journals/cto/2011-8/cto000059.shtml). …”

“…Dura pulsations that could hinder the curing process of the hydroxyapatite cement are retained by the underlying titanium mesh [36], [59], [105]. …”