Treatment of Malar and Midfacial Fractures With Osteoconductive Forged Unsintered Hydroxyapatite and Poly-L-Lactide Composite Internal Fixation Devices

Landes, Constantin A.; Ballon, Alexander; Ghanaati, Sharam; Tran, Andreas; Sader, Robert

doi:10.1016/j.joms.2014.02.027

Cited by 34 publications

(55 citation statements)

References 34 publications

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“…Therefore, a bioabsorbable plate is ideal for fixing fractured bone because of its durability early after the injury and long-term absorption. [2][3][4][5] Despite potential post-fixation infection, swelling, and pain, it was considered safe with no serious complications in a study of >200 cases. 3 In addition, SuperFIXSORB MX40, which is 1 mm thick and thermoplastic, is easily cut with scissors and bent after placing in hot water.…”

Section: Discussionmentioning

confidence: 99%

New technique for fixing rib fracture with bioabsorbable plate

Oyamatsu

Ohata

Narita

2016

Asian Cardiovasc Thorac Ann

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Section: Discussionmentioning

confidence: 99%

New technique for fixing rib fracture with bioabsorbable plate

Oyamatsu

Ohata

Narita

2016

Asian Cardiovasc Thorac Ann

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“…Super Fixsorb-MX ® (Japanese trade name; also known as OSTEOTRANS-MX overseas; Takiron Co. Ltd.,Osaka, Japan) is a promising bioactive, osteoconductive, and totally resorbable osteosynthetic bone fixation device that has recently drawn attention for its long-term clinical stability in maxillofacial skeletal fixation and reconstruction 4,5) . The device material, which is a composite of fine unsintered hydroxyapatite (u-HA) particles and carbonated ions combined with poly-L-lactide (PLLA; u-HA/ PLLA), has a mechanical strength approximating that of human with mechanically rigid and stable strength, even for thin sheets and plates [4][5][6][7] . Thus, u-HA/PLLA composites are of great interest as a candidate material for orbital wall reconstruction because of their advantageous physical properties, high levels of customizability and control, and sufficient stability to support the orbital content.…”

Section: Introductionmentioning

confidence: 99%

“…The resulting release of small amounts of PLLA debris has not been shown to provoke adverse tissue responses in experimental or clinical studies [4][5][6][7]13,14) . Thus, u-HA/PLLA has the advantage of preventing foreign-body reactions because of its moderate and stable hydrolysis.…”

mentioning

confidence: 99%

“…Altogether, u-HA/PLLA composite sheets with tack fixation have substantial clinical advantages and potential for broader applications in maxillofacial fracture repair surgery, such as more complex, complicated, or comminuted periorbital and midfacial fractures or bone regenerative surgical sites [5][6][7] . Computer-assisted surgery (CAS) could greatly improve outcomes in these types of complicated fracture surgeries [16][17][18] .…”

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confidence: 99%

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Applicability of an Unsintered Hydroxyapatite Particles/Poly-L-Lactide Composite Sheet with Tack Fixation for Orbital Fracture Reconstruction

Kanno

Tatsumi

Karino

et al. 2016

J. Hard Tissue Biology.

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The aim of this retrospective clinical study was to evaluate the applicability of newly developed uncalcined and unsintered hydroxyapatite (u-HA) particles and poly-L-lactide (PLLA; u-HA/PLLA) composite sheets with tack fixation for navigation-assisted orbital fracture reconstruction. Osteosynthetic bone fixation and reconstruction systems made from u-HA/PLLA composites have recently drawn attention for effective application in maxillofacial bone surgery because of their osteoconductive properties and bioresorbability. One limitation of these systems in the clinical setting, however, is the complicated drill hole tapping that is required for screw fixation. Herein, we report the feasible application of a u-HA/PLLA sheet with tack fixation for intraoperative navigation-assisted orbital wall reconstruction; this approach may be suitable for fragile and anatomically complicated periorbital-maxillofacial bony regions. The study included 9 patients (mean age, 46.6 years) with moderate and medium complexity to large and high complexity orbital wall defects (3 type II defects and 6 type III). The mean follow-up period was 8.9 months (range, 6 to 18 months). Overall, the application of the u-HA/PLLA sheet with tack fixation gave excellent stability for orbital wall reconstruction at the infraorbital rim, and produced satisfactory ophthalmologic functional results with no intraoperative or postoperative complications. This material may be an optimal bioactive, osteoconductive, and bioresorbable bone alternative for orbital wall reconstruction with fewer complications in patients with orbital fractures.

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“…Autografts are considered the clinical gold standard for orbital reconstruction, although allografts and alloplastic materials are applied as well. [3][4][5][6][7] Because autografts and allografts are poorly shapeable, available in limited quantities and characterized by uncontrolled degradation, these are not ideal for orbital reconstruction. Use of degradable, osteoinductive or -conductive and anatomically shaped alloplastic materials is preferred so that de novo bone may replace the implant and the orbital volume is restored.…”

Section: Introductionmentioning

confidence: 99%

Fabrication of patient specific composite orbital floor implants by stereolithography

Geven

Varjas

Kamer

et al. 2015

Polymers for Advanced Techs

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Fractures of the orbital floor are common in traffic accidents and assaults, and inadequate treatment can result in serious complications. Accurate anatomical reconstruction of the orbit using implants is the preferred treatment. Implants require degradability, adequate mechanical properties to support the orbital contents, and osteoinductivity or osteoconductivity so that the implant is replaced by de novo bone over time. Here, we report on a semi-automatic process for the generation of virtual models of patient-specific implants for orbital floor reconstruction. These models were generated using clinical computed tomography images of five clinical cases of orbital fracture. To fabricate accurately shaped implants based on the models, we utilized stereolithography, a high-resolution additive manufacturing technique. We prepared resins from bioresorbable, photo-curable functionalized poly(trimethylene carbonate) oligomers and osteoinductive nano-hydroxyapatite to manufacture composite implants. Incorporation of 40 wt.% nano-hydroxyapatite into photo-crosslinked poly(trimethylene carbonate) leads to an increase of the E modulus, ultimate strength and toughness from 2.8 to 60 MPa, 2.4 to 7.1 N/mm2 and 330 to 1671 N/mm2, respectively. Additionally, water uptake increased from 0.8% to 7.3%, and water contact angle decreased from 80°to 68°. Patient-specific, homogeneous, and mechanically stable implants can readily be prepared using these composite resins.

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Treatment of Malar and Midfacial Fractures With Osteoconductive Forged Unsintered Hydroxyapatite and Poly-L-Lactide Composite Internal Fixation Devices

Cited by 34 publications

References 34 publications

New technique for fixing rib fracture with bioabsorbable plate

New technique for fixing rib fracture with bioabsorbable plate

Applicability of an Unsintered Hydroxyapatite Particles/Poly-L-Lactide Composite Sheet with Tack Fixation for Orbital Fracture Reconstruction

Fabrication of patient specific composite orbital floor implants by stereolithography

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