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Facial Skeletal Augmentation Using Hydroxyapatite Cement

Facial Skeletal Augmentation Using Hydroxyapatite Cement Abstract • This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans. (Arch Otolaryngol Head Neck Surg. 1993;119:185-190) References 1. Jackson IT, Helden G, Marx R. Skull bone grafts in maxillofacial and craniofacial surgery . J Oral Maxillofac Surg . 1986;44:949-955.Crossref 2. Maves MD, Matt BH. Calvarial bone grafts in head and neck reconstruction . Otolaryngol Head Neck Surg . 1986;95:464-470. 3. Tessier P. Autogenous bone grafts taken from the calvarium for facial and cranial applications . Clin Plast Surg . 1982;9:531-538. 4. Oklund SA, Prolo DJ, Gutierrez RV, King SE. Quantitative comparisons of healing in cranial fresh autografts, frozen autografts, and processed autografts, and allografts in canine skull defects . Clin Orthop . 1986;205: 269-291. 5. Welling HB, Maves MD, Schuller DE, Bardach J. Use of irradiated cartilage for facial contour restoration: a 10-year follow-up . Arch Otolaryngol Head Neck Surg . 1988;114:291-295.Crossref 6. Mulliken JB, Glowacki J, Kaban LB, Folkman J, Murray JE. Use of demineralized allogeneic bone implants for the correction of maxillocraniofacial deformities . Ann Surg . 1981;3:366-372.Crossref 7. Ousterhout DK. Clinical experience in cranial and facial reconstruction with demineralized bone . Ann Plast Surg . 1985;15:367-373.Crossref 8. Toriumi DM, Larrabee WF Jr, Walike JW, Millay DJ, Eisele DW. Demineralized bone: implant resorption with long-term follow-up . Arch Otolaryngol Head Neck Surg . 1990;116:676-680.Crossref 9. Zarem HA. Silastic implants in plastic surgery . Surg Clin North Am . 1968;48:129-142. 10. Beekhuis GJ. Polyamide mesh used in facial plastic surgery . Arch Otolaryngol Head Neck Surg . 1980;1106:642-644.Crossref 11. Stucker FJ, Hirokawa RRH, Pruet CW. The autoalloplast: an alternative in face implantation . Otolaryngol Clin North Am . 1982;15:161-168. 12. Parks ML, Kameer FM. Proplast chin augmentation . Laryngoscope . 1976;86:1829-1835.Crossref 13. Epstein LI. Clinical experiences with Proplast as an implant . Plast Reconstr Surg . 1979;63:219-223.Crossref 14. Rubin LR. Polyethylene as a bone and cartilage substitute: 32-year retrospective . In: Rubin LR, ed. Biomaterials in Reconstructive Surgery . St Louis, Mo: Mosby–Year Book; 1982:474-482. 15. Maas CS, Merwin GE, Wilson J, Frey MD, Maves MD. Comparison of biomaterials for facial bone augmentation . Arch Otolaryngol Head Neck Surg . 1990;116:551-556.Crossref 16. Rish BL, Dillon JD, Meirowsky AM, et al. Cranioplasty: a review of 1030 cases of penetrating head injury . Neurosurgery . 1979;4:381-390.Crossref 17. Toth BA, Ellis DS, Stewart WB. Computer-designed prostheses for orbitocranial reconstruction . Plast Reconstr Surg . 1988;81:315-324.Crossref 18. Holmes RE. Bone regeneration within a corralline hydroxyapatite implant . Plast Reconstr Surg . 1979;63:626-633.Crossref 19. Jarcho M, Kay JF, Gumaer KI, et al. Tissue, cellular and subcellular events at a bone-ceramic hydroxyapatite interface . J Bioeng . 1977;1:79-92. 20. Ducheyne P, Hench L, Kagan A, et al. Effect of hydroxyapatite impregnation on skeletal bonding of porous coated implants . J Biomed Mater Res . 1980;14:225-237.Crossref 21. Kent JN, Quinn JH, Zide MF, et al. Alveolar ridge augmentation using non-resorbable hydroxyapatite with or without autogenous cancellous bone . J Oral Maxillofac Surg . 1983;41:629-642.Crossref 22. Kent JN. Reconstruction of the alveolar ridge with hydroxyapatite . Dent Clin North Am . 1986;30:231-257. 23. Kent JN, Zide MF, Kay JF. Hydroxyapatite blocks and particles as bone graft substitutes in orthognathic and reconstructive surgery . J Oral Maxillofac Surg . 1986;44:597-605.Crossref 24. Kent JN. Reconstruction of the alveolar ridge with hydroxyapatite . Reconstr Implant Surg Prosthodont . 1986;30:231-257. 25. Block MS, Kent JN, Ardoin RC, Davenport W. Mandibular augmentation in dogs with hydroxyapatite combined with demineralized bone . J Oral Maxillofac Surg . 1987;45:414-420.Crossref 26. Piecuch JF, Fedorka NJ. Results of soft-tissue surgery over implanted replamineform hydroxyapatite . J Oral Maxillofac Surg . 1983;41:801-806.Crossref 27. Brown WE, Chow LC. A new calcium phosphate, water-setting cement . In: Brown PW, ed. Cements Research Progress . Westerville, Ohio: American Ceramic Society; 1986:352-379. 28. Chow LC, Takagi S, Costantino PD, Friedman CD. Self-setting calcium phosphate cements . Mater Res Soc Symp Proc . 1991;179:3-24. 29. Costantino PD, Friedman CD, Jones K, Chow LD, Pelzer HJ, Sisson GA Sr. Evaluation of a new hydroxyapatite cement: basic chemistry and histology . Arch Otolaryngol Head Neck Surg . 1991;117:379-384.Crossref 30. Friedman CD, Costantino PD, Jones K, Chow LD, Pelzer HJ, Sisson GA Sr. Evaluation of a new hydroxyapatite cement: obliteration and reconstruction of the cat frontal sinus . Arch Otolaryngol Head Neck Surg . 1991;117: 385-389.Crossref 31. Costantino PD, Friedman CD, Jones K, Chow LD, Sisson GA Sr. Experimental hydroxyapatite cement cranioplasty. Plast Reconstr Surg. In press. 32. Shen K, Gongloff RK. Collagen tube containers: an effective means of controlling particulate hydroxyapatite implants . J Prosthet Dent . 1986;56: 65-70.Crossref 33. Mehlisch DR, Taylor TD, Leibold DG, et al. Evaluation of collagen/hydroxyapatite for augmenting deficient alveolar ridges: a preliminary report . J Oral Maxillofac Surg . 1987;45:408-413.Crossref 34. Holmes RE, Hagler KH. Porous hydroxyapatite as a bone graft substitute in cranial reconstruction: a histometric study . Plast Reconstr Surg . 1988; 81:6662-6671.Crossref 35. Felsenfeld AJ, Harrelson JM, Gutman RA. A quantitative histomorphometric comparison of 40 micron thick paragon sections with 5 micron thick Goldner sections in the study of undecalcified bone . Calcif Tissue Int . 1982;34:232-238.Crossref 36. Toriumi DM, Kotler HS, Luxenberg DP, Holtrop ME, Wang EA. Mandibular reconstruction with recombinant bone-inducing factor: functional and biomechanical evaluation . Arch Otolaryngol Head Neck Surg . 1991; 117:1101-1112.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Facial Skeletal Augmentation Using Hydroxyapatite Cement

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1993.01880140069012
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Abstract

Abstract • This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans. (Arch Otolaryngol Head Neck Surg. 1993;119:185-190) References 1. Jackson IT, Helden G, Marx R. Skull bone grafts in maxillofacial and craniofacial surgery . J Oral Maxillofac Surg . 1986;44:949-955.Crossref 2. Maves MD, Matt BH. Calvarial bone grafts in head and neck reconstruction . Otolaryngol Head Neck Surg . 1986;95:464-470. 3. Tessier P. Autogenous bone grafts taken from the calvarium for facial and cranial applications . Clin Plast Surg . 1982;9:531-538. 4. Oklund SA, Prolo DJ, Gutierrez RV, King SE. Quantitative comparisons of healing in cranial fresh autografts, frozen autografts, and processed autografts, and allografts in canine skull defects . Clin Orthop . 1986;205: 269-291. 5. Welling HB, Maves MD, Schuller DE, Bardach J. Use of irradiated cartilage for facial contour restoration: a 10-year follow-up . Arch Otolaryngol Head Neck Surg . 1988;114:291-295.Crossref 6. Mulliken JB, Glowacki J, Kaban LB, Folkman J, Murray JE. Use of demineralized allogeneic bone implants for the correction of maxillocraniofacial deformities . Ann Surg . 1981;3:366-372.Crossref 7. Ousterhout DK. Clinical experience in cranial and facial reconstruction with demineralized bone . Ann Plast Surg . 1985;15:367-373.Crossref 8. Toriumi DM, Larrabee WF Jr, Walike JW, Millay DJ, Eisele DW. Demineralized bone: implant resorption with long-term follow-up . Arch Otolaryngol Head Neck Surg . 1990;116:676-680.Crossref 9. Zarem HA. Silastic implants in plastic surgery . Surg Clin North Am . 1968;48:129-142. 10. Beekhuis GJ. Polyamide mesh used in facial plastic surgery . Arch Otolaryngol Head Neck Surg . 1980;1106:642-644.Crossref 11. Stucker FJ, Hirokawa RRH, Pruet CW. The autoalloplast: an alternative in face implantation . Otolaryngol Clin North Am . 1982;15:161-168. 12. Parks ML, Kameer FM. Proplast chin augmentation . Laryngoscope . 1976;86:1829-1835.Crossref 13. Epstein LI. Clinical experiences with Proplast as an implant . Plast Reconstr Surg . 1979;63:219-223.Crossref 14. Rubin LR. Polyethylene as a bone and cartilage substitute: 32-year retrospective . In: Rubin LR, ed. Biomaterials in Reconstructive Surgery . St Louis, Mo: Mosby–Year Book; 1982:474-482. 15. Maas CS, Merwin GE, Wilson J, Frey MD, Maves MD. Comparison of biomaterials for facial bone augmentation . Arch Otolaryngol Head Neck Surg . 1990;116:551-556.Crossref 16. Rish BL, Dillon JD, Meirowsky AM, et al. Cranioplasty: a review of 1030 cases of penetrating head injury . Neurosurgery . 1979;4:381-390.Crossref 17. Toth BA, Ellis DS, Stewart WB. Computer-designed prostheses for orbitocranial reconstruction . Plast Reconstr Surg . 1988;81:315-324.Crossref 18. Holmes RE. Bone regeneration within a corralline hydroxyapatite implant . Plast Reconstr Surg . 1979;63:626-633.Crossref 19. Jarcho M, Kay JF, Gumaer KI, et al. Tissue, cellular and subcellular events at a bone-ceramic hydroxyapatite interface . J Bioeng . 1977;1:79-92. 20. Ducheyne P, Hench L, Kagan A, et al. Effect of hydroxyapatite impregnation on skeletal bonding of porous coated implants . J Biomed Mater Res . 1980;14:225-237.Crossref 21. Kent JN, Quinn JH, Zide MF, et al. Alveolar ridge augmentation using non-resorbable hydroxyapatite with or without autogenous cancellous bone . J Oral Maxillofac Surg . 1983;41:629-642.Crossref 22. Kent JN. Reconstruction of the alveolar ridge with hydroxyapatite . Dent Clin North Am . 1986;30:231-257. 23. Kent JN, Zide MF, Kay JF. Hydroxyapatite blocks and particles as bone graft substitutes in orthognathic and reconstructive surgery . J Oral Maxillofac Surg . 1986;44:597-605.Crossref 24. Kent JN. Reconstruction of the alveolar ridge with hydroxyapatite . Reconstr Implant Surg Prosthodont . 1986;30:231-257. 25. Block MS, Kent JN, Ardoin RC, Davenport W. Mandibular augmentation in dogs with hydroxyapatite combined with demineralized bone . J Oral Maxillofac Surg . 1987;45:414-420.Crossref 26. Piecuch JF, Fedorka NJ. Results of soft-tissue surgery over implanted replamineform hydroxyapatite . J Oral Maxillofac Surg . 1983;41:801-806.Crossref 27. Brown WE, Chow LC. A new calcium phosphate, water-setting cement . In: Brown PW, ed. Cements Research Progress . Westerville, Ohio: American Ceramic Society; 1986:352-379. 28. Chow LC, Takagi S, Costantino PD, Friedman CD. Self-setting calcium phosphate cements . Mater Res Soc Symp Proc . 1991;179:3-24. 29. Costantino PD, Friedman CD, Jones K, Chow LD, Pelzer HJ, Sisson GA Sr. Evaluation of a new hydroxyapatite cement: basic chemistry and histology . Arch Otolaryngol Head Neck Surg . 1991;117:379-384.Crossref 30. Friedman CD, Costantino PD, Jones K, Chow LD, Pelzer HJ, Sisson GA Sr. Evaluation of a new hydroxyapatite cement: obliteration and reconstruction of the cat frontal sinus . Arch Otolaryngol Head Neck Surg . 1991;117: 385-389.Crossref 31. Costantino PD, Friedman CD, Jones K, Chow LD, Sisson GA Sr. Experimental hydroxyapatite cement cranioplasty. Plast Reconstr Surg. In press. 32. Shen K, Gongloff RK. Collagen tube containers: an effective means of controlling particulate hydroxyapatite implants . J Prosthet Dent . 1986;56: 65-70.Crossref 33. Mehlisch DR, Taylor TD, Leibold DG, et al. Evaluation of collagen/hydroxyapatite for augmenting deficient alveolar ridges: a preliminary report . J Oral Maxillofac Surg . 1987;45:408-413.Crossref 34. Holmes RE, Hagler KH. Porous hydroxyapatite as a bone graft substitute in cranial reconstruction: a histometric study . Plast Reconstr Surg . 1988; 81:6662-6671.Crossref 35. Felsenfeld AJ, Harrelson JM, Gutman RA. A quantitative histomorphometric comparison of 40 micron thick paragon sections with 5 micron thick Goldner sections in the study of undecalcified bone . Calcif Tissue Int . 1982;34:232-238.Crossref 36. Toriumi DM, Kotler HS, Luxenberg DP, Holtrop ME, Wang EA. Mandibular reconstruction with recombinant bone-inducing factor: functional and biomechanical evaluation . Arch Otolaryngol Head Neck Surg . 1991; 117:1101-1112.Crossref

Journal

Archives of Otolaryngology - Head & Neck Surgery – American Medical Association

Published: Feb 1, 1993

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