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Alfotawi R. Compact Silicon Carbide Bio Glass Graft Material for Bone Augmentation. J Craniofac Surg 2025:00001665-990000000-02659. [PMID: 40273032 DOI: 10.1097/scs.0000000000011421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Accepted: 03/30/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND The significant clinical demand for bone augmentation and the reported complications with the current biomaterials make it an essential area of research. Using a rat model, the study explores the role of dense bioactive silicon carbide (SiC) ceramic and evaluates its integration to long bone. MATERIALS AND METHODS SiC cylinders were made at the dimension of 5×3×5 mm using SiC particles size 40 μm and were fabricated by exposing SiC particles to 15% NaOH for 15 minutes before they were mixed with the smaller SiC particles. Thereafter, they were heated to 650 °C for 5 hours. The biocompatibility and osteogencity of the SiC-compacted cylinders were then evaluated in vitro. After being cultured on the surface of SiC compact cylinders, mesenchymal stromal cells (MSCs) were evaluated for cell viability and differentiation using semi-quantitative RT-PCR, quantitative Alkaline Phosphatase (ALP) expression, and scanning electron microscopy. The material was then tested in vivo on 18 rats. After 12 weeks, the transplanted tissues were removed and subjected to mechanical, radiograph, and histologic analysis, including immunohistochemistry for osteopontin and S100. RESULTS Osteogenic potential and SiC biocompatibility were noted. More radio-opacity that was indistinguishable from the cortical native bone was observed on cone-beam computed tomography for the samples; no radiolucent space was visible, indicating integration with bone. In comparison to the control group, the grafted long bone group exhibited a statistically significant greater Maximum Load and a high mechanical flexural strength compared with non-operated bone (P<0.001). Histologically, SiC integration was observed; mixed lamellar and woven bone is shown in the native bone, and osteoblastic cells were present at the edges of SiC. This was verified by positive osteopontin staining at the interface area. Moreover, positive staining at the interface area for S100 antibody indicates the innervation of the newly formed bone. CONCLUSION The tested construct made of compact SiC has potential to osteointegration into native bone, making it a suitable material for bone augmentation.
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Affiliation(s)
- Randa Alfotawi
- Department of Oral and Maxillofacial Surgery, Dental Faculty, King Saud University. King Saud University, Riyadh, Kingdom of Saudia Arabia
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Phillips AL, Allen MA, Mukit FA, Bone TM, Noguera CM, Fowler BT, Gleysteen JP. Intraosseous Hemangioma of the Zygomatic Bone with Multidisciplinary Approach to Surgical Resection and Orbital Reconstruction. EPLASTY 2024; 24:e27. [PMID: 38846502 PMCID: PMC11155339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background Intraosseous hemangiomas are rare benign tumors comprising fewer than 1% of all osseous tumors; even more uncommon are intraosseous hemangiomas of the zygomatic bone. This case reports a multidisciplinary approach for excision and reconstruction of an intraosseous hemangioma of the zygomatic bone in a 54-year-old female. Methods Multidisciplinary approach with both otolaryngology head and neck surgery and oculofacial plastics and reconstructive surgery included right lateral canthotomy and right transconjunctival orbitotomy with en-bloc excision of the zygomatic arch, followed by reconstruction of the orbital rim, orbital floor, and eyelid with Medpor implant. Results Final surgical pathology was consistent with intraosseous hemangioma of the zygomatic bone. At 4-month follow-up, the patient was healing well with good midface projection and without any visual deficits. Conclusions A multidisciplinary coordinated case allowed us to meet the standard of maintaining cosmesis and function while undergoing resection of a rare tumor involving a key facial structure-the zygoma. Involvement of oculofacial plastics and reconstructive surgery service allowed for advanced eyelid reconstruction techniques to limit any functional impairment to our patient with deliberate choice of implant material for well-adhered, durable, and aesthetically optimal reconstruction of the right malar eminence, lateral orbital rim, and orbital floor defect. The postoperative result through the multidisciplinary approach was a near symmetrical facial reconstruction without any associated eyelid or globe abnormalities.
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Affiliation(s)
- Alisa L. Phillips
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Meredith A. Allen
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Fabliha A. Mukit
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - Tyler M. Bone
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Cynthia M. Noguera
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - Brian T. Fowler
- Department of Oculofacial Plastics and Reconstructive Surgery, University of Tennessee Health Science Center College of Medicine, Hamilton Eye Institute, Memphis, Tennessee
| | - John P. Gleysteen
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
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Akhavan AA, Pang JH, Morrison SD, Satterwhite T. Gender Affirming Facial Surgery-Anatomy and Procedures for Facial Masculinization. Oral Maxillofac Surg Clin North Am 2024; 36:221-236. [PMID: 38458858 DOI: 10.1016/j.coms.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
For some patients, feminine facial features may cause significant gender dysphoria. Multiple nonsurgical and surgical techniques exist to masculinize facial features. Nonsurgical techniques include testosterone supplementation and dermal fillers. Surgical techniques include soft tissue manipulation, synthetic implants, regenerative scaffolding, or bony reconstruction. Many techniques are derived from experience with cisgender patients, but are adapted with special considerations to differing anatomy between cisgender and transgender men and women. Currently, facial masculinization is less commonly sought than feminization, but demand is likely to increase as techniques are refined and made available.
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Affiliation(s)
- Arya Andre Akhavan
- Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Suite E1620, Newark, NJ 07103, USA; Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - John Henry Pang
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA
| | - Shane D Morrison
- Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356165, Seattle, WA 98195, USA
| | - Thomas Satterwhite
- Align Surgical Associates, 2299 Post Street, Suite 207, San Francisco, CA 94115, USA; Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center.
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Systermans S, Cobraiville E, Camby S, Meyer C, Louvrier A, Lie SA, Schouman T, Siciliano S, Beckers O, Poulet V, Ullmann N, Nolens G, Biscaccianti V, Nizet JL, Hascoët JY, Gilon Y, Vidal L. An innovative 3D hydroxyapatite patient-specific implant for maxillofacial bone reconstruction: A case series of 13 patients. J Craniomaxillofac Surg 2024; 52:420-431. [PMID: 38461138 DOI: 10.1016/j.jcms.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/28/2023] [Accepted: 02/17/2024] [Indexed: 03/11/2024] Open
Abstract
The study aimed to evaluate and discuss the use of an innovative PSI made of porous hydroxyapatite, with interconnected porosity promoting osteointegration, called MyBone Custom® implant (MBCI), for maxillofacial bone reconstruction. A multicentric cohort of 13 patients underwent maxillofacial bone reconstruction surgery using MBCIs for various applications, from genioplasty to orbital floor reconstruction, including zygomatic and mandibular bone reconstruction, both for segmental defects and bone augmentation. The mean follow-up period was 9 months (1-22 months). No infections, displacements, or postoperative fractures were reported. Perioperative modifications of the MBCIs were possible when necessary. Additionally, surgeons reported significant time saved during surgery. For patients with postoperative CT scans, osteointegration signs were visible at the 6-month postoperative follow-up control, and continuous osteointegration was observed after 1 year. The advantages and disadvantages compared with current techniques used are discussed. MBCIs offer new bone reconstruction possibilities with long-term perspectives, while precluding the drawbacks of titanium and PEEK. The low level of postoperative complications associated with the high osteointegration potential of MBCIs paves the way to more extensive use of this new hydroxyapatite PSI in maxillofacial bone reconstruction.
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Affiliation(s)
- Simon Systermans
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium; Department of Oral and Maxillofacial Surgery, ZOL Genk, Genk, Belgium
| | | | - Séverine Camby
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Christophe Meyer
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU, Université de Franche-Comté, Besançon, France
| | - Aurélien Louvrier
- Chirurgie Maxillo-Faciale, Stomatologie et Odontologie Hospitalière, CHU, Université de Franche-Comté, Besançon, France
| | - Suen An Lie
- Department of Cranio-Maxillofacial Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Thomas Schouman
- Department of Maxillofacial Surgery, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Sergio Siciliano
- Department of Stomatology and Maxillofacial Surgery, Clinique Sainte Elisabeth, Brussels, Belgium
| | - Olivier Beckers
- Department of Oral and Maxillofacial Surgery, ZOL Genk, Genk, Belgium
| | - Vinciane Poulet
- Department of Maxillofacial Surgery, Toulouse Purpan University Hospital, Toulouse, France
| | - Nicolas Ullmann
- Service de Chirurgie Maxillo-faciale et Stomatologie, Hôpital de Villeneuve Saint Georges, France
| | | | - Vincent Biscaccianti
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France
| | - Jean-Luc Nizet
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Jean-Yves Hascoët
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France
| | - Yves Gilon
- Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium
| | - Luciano Vidal
- Research Institute of Civil Engineering and Mechanics (GeM), CNRS, Nantes, France; Department of Plastic and Reconstructive Surgery, Clinique Bretéché - ELSAN, Nantes, France.
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Wagner J, Luck S, Loger K, Açil Y, Spille JH, Kurz S, Ahlhelm M, Schwarzer-Fischer E, Ingwersen LC, Jonitz-Heincke A, Sedaghat S, Wiltfang J, Naujokat H. Bone regeneration in critical-size defects of the mandible using biomechanically adapted CAD/CAM hybrid scaffolds: An in vivo study in miniature pigs. J Craniomaxillofac Surg 2024; 52:127-135. [PMID: 38129185 DOI: 10.1016/j.jcms.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
The study aimed to analyze bone regeneration in critical-size defects using hybrid scaffolds biomechanically adapted to the specific defect and adding the growth factor rhBMP-2. For this animal study, ten minipigs underwent bilateral defects in the corpus mandibulae and were subsequently treated with novel cylindrical hybrid scaffolds. These scaffolds were designed digitally to suit the biomechanical requirements of the mandibular defect, utilizing finite element analysis. The scaffolds comprised zirconium dioxide-tricalcium phosphate (ZrO2-TCP) support struts and TCP foam ceramics. One scaffold in each animal was loaded with rhBMP-2 (100 μg/cm³), while the other served as an unloaded negative control. Fluorescent dyes were administered every 2 weeks, and computed tomography (CT) scans were conducted every 4 weeks. Euthanasia was performed after 3 months, and samples were collected for examination using micro-CT and histological evaluation of both hard and soft tissue. Intravital CT examinations revealed minor changes in radiographic density from 4 to 12 weeks postoperatively. In the group treated with rhBMP-2, radiographic density shifted from 2513 ± 128 (mean ± SD) to 2606 ± 115 Hounsfield units (HU), while the group without rhBMP-2 showed a change from 2430 ± 131 to 2601 ± 67 HU. Prior to implantation, the radiological density of samples measured 1508 ± 30 mg HA/cm³, whereas post-mortem densities were 1346 ± 71 mg HA/cm³ in the rhBMP-2 group and 1282 ± 91 mg HA/cm³ in the control group (p = 0.045), as indicated by micro-CT measurements. The histological assessment demonstrated successful ossification in all specimens. The newly formed bone area proportion was significantly greater in the rhBMP-2 group (48 ± 10%) compared with the control group without rhBMP-2 (42 ± 9%, p = 0.03). The mean area proportion of remaining TCP foam was 23 ± 8% with rhBMP-2 and 24 ± 10% without rhBMP-2. Successful bone regeneration was accomplished by implanting hybrid scaffolds into critical-size mandibular defects. Loading these scaffolds with rhBMP-2 led to enhanced bone regeneration and a uniform distribution of new bone formation within the hybrid scaffolds. Further studies are required to determine the adaptability of hybrid scaffolds for larger and potentially segmental defects in the maxillofacial region.
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Affiliation(s)
- Juliane Wagner
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Cluster of Excellence, Precision Medicine in Inflammation, Christian-Albrechts-University of Kiel, Kiel, Germany.
| | - Sascha Luck
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Klaas Loger
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Yahya Açil
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Johannes H Spille
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sascha Kurz
- ZESBO - Center for Research on Musculoskeletal Systems, Leipzig University, Leipzig, Germany
| | - Matthias Ahlhelm
- Fraunhofer Institute for Ceramic Technologies and Systems, IKTS, Dresden, Germany
| | | | - Lena-Christin Ingwersen
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - Anika Jonitz-Heincke
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, Rostock University Medical Center, Rostock, Germany
| | - Sam Sedaghat
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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La Padula S, Coiante E, Beneduce N, Valentini V, D'Andrea L, Giudice GL, Pensato R, Ungerer L, Hersant B, Meningaud JP. Assessment of deep plane facelift in facial feminization surgery: A prospective pilot study. J Plast Reconstr Aesthet Surg 2023; 85:425-435. [PMID: 37579653 DOI: 10.1016/j.bjps.2023.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/03/2023] [Accepted: 07/16/2023] [Indexed: 08/16/2023]
Abstract
Facial feminization surgery (FFS) is often the first procedure requested by patients wishing to undergo gender-affirming surgery. This study aims to evaluate the applicability and effectiveness of deep plane facelifts in FFS. The authors conducted a prospective study that included patients who requested a deep plane facelift as a standalone procedure to achieve a more feminine facial appearance as the only procedure of FFS. These patients underwent deep plane facelifts to achieve a more feminine oval face shape and increased tissue projection of the zygomatic-malar region. To assess the effectiveness of the procedure and patient satisfaction, the Face-Q scales, Face and Neck lift Objective Photo-Numerical Assessment Scale, the Satisfaction With Life Scale, and the Subjective Happiness Scale were applied preoperatively and one year after surgery. Thirty-six patients were included in the study. A statistically significant difference (p < 0.005) was observed between pre and postoperative scores. The repositioning of the malar fat pads increased the malar volume, providing a more oval overall shape of the face, which is typically feminine. No major complications were observed. Despite our encouraging results, new studies with a larger sample of patients are needed to support the benefits of the deep plane facelift as part of FFS to elevate this technique from an ancillary to a routine procedure for patients undergoing gender affirmation surgery.
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Affiliation(s)
- Simone La Padula
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy.
| | - Edoardo Coiante
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Nicola Beneduce
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Roma, Italy
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Via Caserta 6, 00161 Roma, Italy
| | - Luca D'Andrea
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University of Naples "Federico II", Via Pansini, 5, 80131 Naples, Italy
| | - Rosita Pensato
- Department of Plastic and Reconstructive Surgery, Università degli studi di Napoli Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Lucas Ungerer
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Barbara Hersant
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Jean Paul Meningaud
- Department of Plastic, Reconstructive, and Maxillofacial Surgery, Henri Mondor Hospital, University Paris XII, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
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Dżaman K, Ziemska-Gorczyca M, Anurin I, Błaszczyk M. The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors. Healthcare (Basel) 2023; 11:1663. [PMID: 37372781 DOI: 10.3390/healthcare11121663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/24/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Reconstructive surgery after surgical treatment of neoplasms in the head and neck region is always a challenge. Many factors are responsible for the success of reconstruction. The anatomy of the facial region is complex, which significantly influences the aesthetic effect of the reconstruction. Moreover, many patients undergo postoperative radiotherapy after surgical treatment, which affects the range of reconstructive techniques. The aim of this study is to review current reconstructive methods in the craniofacial region, using bone-anchored implants to attach nasal prostheses. The article also comprises the authors' own experience with successful single-stage, Vistafix 3 osseointegrated implants for the attachment of an external nasal prosthesis in a 51-year-old man after surgical removal of squamous cell carcinoma of the nose and paranasal sinuses. The literature search for articles regarding implants in craniofacial reconstructions was performed using the three following databases: Scopus, Web of Science and MEDLINE (through PubMed), and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). A systematic literature search was set for 2018-2023 and retrieved 92 studies. From them, 18 articles were included in the review.
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Affiliation(s)
- Karolina Dżaman
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Marlena Ziemska-Gorczyca
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Igor Anurin
- Department of Otolaryngology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
| | - Magdalena Błaszczyk
- Faculty of Science and Technology, University of Silesia in Katowice, 40-007 Katowice, Poland
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Panneerselvam E, Parameswaran A, Ramanathan M, Mukherjee B. Ramal bone graft for management of infra-orbital rim fractures with defects - Technical note and a series of 16 cases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e581-e587. [PMID: 35452864 DOI: 10.1016/j.jormas.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/17/2022] [Indexed: 06/14/2023]
Abstract
The purpose is to describe a technique of using ramal bone graft for reconstructing defects of the infra-orbital rim (IOR), assess outcomes and complications. This was a retrospective chart review of 16 patients who underwent ramal bone grafting for IOR fractures. Outcomes evaluated were improvement in clinical findings (lid/globe malposition, tethering of facial skin and implant extrusion) and complications. Data analysis included descriptive statistics. The sample included 15 males and 1 female, with a mean age of 31.6 years. Lid malposition, globe malposition and tethering of facial skin was seen in 16, 13 and 6 patients, respectively. One patient demonstrated extrusion of implant. The mean size of bone harvested was 14 × 7 mm. All patients demonstrated improved globe position post-treatment, while 3 had residual lid retraction. Two patients demonstrated wound dehiscence in the donor site. In conclusion ramal bone graft was found to be a viable alternative for IOR reconstruction.
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Affiliation(s)
| | | | - Mrunalini Ramanathan
- Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Bipasha Mukherjee
- Oculoplasty and Orbital Surgery, Shankara Nethralaya, Chennai 600006, India
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Laser Sintering Approaches for Bone Tissue Engineering. Polymers (Basel) 2022; 14:polym14122336. [PMID: 35745911 PMCID: PMC9229946 DOI: 10.3390/polym14122336] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
The adoption of additive manufacturing (AM) techniques into the medical space has revolutionised tissue engineering. Depending upon the tissue type, specific AM approaches are capable of closely matching the physical and biological tissue attributes, to guide tissue regeneration. For hard tissue such as bone, powder bed fusion (PBF) techniques have significant potential, as they are capable of fabricating materials that can match the mechanical requirements necessary to maintain bone functionality and support regeneration. This review focuses on the PBF techniques that utilize laser sintering for creating scaffolds for bone tissue engineering (BTE) applications. Optimal scaffold requirements are explained, ranging from material biocompatibility and bioactivity, to generating specific architectures to recapitulate the porosity, interconnectivity, and mechanical properties of native human bone. The main objective of the review is to outline the most common materials processed using PBF in the context of BTE; initially outlining the most common polymers, including polyamide, polycaprolactone, polyethylene, and polyetheretherketone. Subsequent sections investigate the use of metals and ceramics in similar systems for BTE applications. The last section explores how composite materials can be used. Within each material section, the benefits and shortcomings are outlined, including their mechanical and biological performance, as well as associated printing parameters. The framework provided can be applied to the development of new, novel materials or laser-based approaches to ultimately generate bone tissue analogues or for guiding bone regeneration.
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Ali S, Abdel Aziz O, Ahmed M. Patient-specific PEEK implants for immediate restoration of temporal fossa after maxillary reconstruction with temporalis muscle flap. Maxillofac Plast Reconstr Surg 2022; 44:20. [PMID: 35524015 PMCID: PMC9076787 DOI: 10.1186/s40902-022-00348-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Temporal hollowing is a common complication following the rotation of the temporalis muscle that leaves the patient with a cosmetic impairment. Several alloplastic materials have been used to reconstruct the donor site; however, these implants need meticulous adaptation to conform the periphery of the defect and restore the contour of the temporal area. The aim of this study was to assess the use of patient-specific polyetheretherketone (PEEK) temporal implants to prevent temporal hollowing following the use of full temporalis muscle flap for large maxillary defects reconstruction. METHODS This was a prospective study conducted on eight patients with major maxillary defects indicating the need of reconstruction with full temporalis muscle flap or any lesion indicating major maxillary resection and immediate reconstruction with total temporalis muscle flap. For each patient, a patient-specific PEEK implant was fabricated using virtual planning and milled from PEEK blocks. In the surgical theater, the temporalis muscle was exposed, elevated, and transferred to the maxilla. After the temporalis muscle transfer, PEEK implants were fixed in place to prevent temporal hollowing. RESULTS The surgical procedures were uneventful for all patients. The esthetic result was satisfactory with no post-operative complications except in one patient where seroma occurred after 2 weeks and resolved after serial aspiration. CONCLUSION Patient-specific PEEK implant appears to facilitate the surgical procedures eliminate several meticulous steps that are mainly based on the surgeon's experience. TRIAL REGISTRATION Clinical trials registration: NCT05240963 .
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Affiliation(s)
- Sherif Ali
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Omniya Abdel Aziz
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Mamdouh Ahmed
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Oral and Maxillofacial Surgery Department, Nasser Institute for Treatment and Research, Cairo, Egypt
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11
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Hudise JY, Aldhabaan SA, Aldosari BF. Complications of the nasal dorsum reconstruction using autologous or alloplastic grafts: evidence from systematic review and meta-analysis. Braz J Otorhinolaryngol 2022; 88:406-420. [PMID: 32888894 PMCID: PMC9422502 DOI: 10.1016/j.bjorl.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/26/2020] [Accepted: 07/04/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Augmentation rhinoplasty depends mainly on intact stable bony and cartilaginous parts. Many trials have used different materials as a graft to perform the operation and support the nose. Debate exists whether alloplastic or autogenic grafts are more appropriate. Common available alloplastic grafts include silicone, medpor, and gore-tex. Autogenic grafts are usually derived from costal cartilages. Warping, infection, and hypertrophic scars are the main complications of the procedure. Yet no subgroup analysis has been performed to investigate the effect of different risk factors. OBJECTIVE To investigate the effect of different types of grafts and the association of the income level of the country on surgery complications. METHODS A comprehensive literature search of articles was conducted in PubMed, Cochrane Library, Web of Science, and SCOPUS databases through October 2019. We included articles that used autologous or alloplastic grafts in nasal dorsum reconstruction surgery. We performed subgroup analysis according to the type of graft used, region, and income level of the country. A meta-regression analysis model was carried out from the period of 1999-2018, to study the incidence of these complications over time. RESULTS The overall complication rate was 7.1%, which was higher in the alloplastic group (7.8%) than the autogenic group (6.9%). The most common complications were secondary surgery for re-correction (4.1%), infection (2.1%), warping (1.6%), and hypertrophic scars (1.6%). All outcomes were homogeneous (I2 < 50%). CONCLUSION Patients with autogenic grafts are less liable to develop complications than their peers reconstructed with alloplastic grafts. Moreover, Asian patients are less susceptible to overall rhinoplasty complications. Attention should be noted for low-income countries in which surgical complications are more prone to occur.
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Affiliation(s)
- Jibril Y Hudise
- Facial Plastic Surgery King Saud University, King Abdulaziz University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia; King Faisal Medical City of Southern Region, Abha, Saudi Arabia.
| | - Saud A Aldhabaan
- Facial Plastic Surgery King Saud University, King Abdulaziz University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia; King Faisal Medical City of Southern Region, Abha, Saudi Arabia
| | - Badi F Aldosari
- Facial Plastic Surgery King Saud University, King Abdulaziz University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia
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12
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Functional reconstruction of the glenoid fossa utilizing a pedicled temporal osteomuscular flap. ORAL AND MAXILLOFACIAL SURGERY CASES 2022. [DOI: 10.1016/j.omsc.2022.100243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Genc A, Isler SC, Oge AE, Matur Z. Effect of Sagittal Split Osteotomy with Medpor ® Porous Polyethylene Implant on Masticatory Reflex. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/qayvwmfrnj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Eckrich J, Hoormann N, Kersten E, Piradashvili K, Wurm FR, Heller M, Becker S, Anusic T, Brieger J, Strieth S. Surface Modification of Porous Polyethylene Implants with an Albumin-Based Nanocarrier-Release System. Biomedicines 2021; 9:1485. [PMID: 34680602 PMCID: PMC8533240 DOI: 10.3390/biomedicines9101485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Porous polyethylene (PPE) implants are used for the reconstruction of tissue defects but have a risk of rejection in case of insufficient ingrowth into the host tissue. Various growth factors can promote implant ingrowth, yet a long-term gradient is a prerequisite for the mediation of these effects. As modification of the implant surface with nanocarriers may facilitate a long-term gradient by sustained factor release, implants modified with crosslinked albumin nanocarriers were evaluated in vivo. METHODS Nanocarriers from murine serum albumin (MSA) were prepared by an inverse miniemulsion technique encapsulating either a low- or high-molar mass fluorescent cargo. PPE implants were subsequently coated with these nanocarriers. In control cohorts, the implant was coated with the homologue non-encapsulated cargo substance by dip coating. Implants were consequently analyzed in vivo using repetitive fluorescence microscopy utilizing the dorsal skinfold chamber in mice for ten days post implantation. RESULTS Implant-modification with MSA nanocarriers significantly prolonged the presence of the encapsulated small molecules while macromolecules were detectable during the investigated timeframe regardless of the form of application. CONCLUSIONS Surface modification of PPE implants with MSA nanocarriers results in the alternation of release kinetics especially when small molecular substances are used and therefore allows a prolonged factor release for the promotion of implant integration.
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Affiliation(s)
- Jonas Eckrich
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.H.); (M.H.); (J.B.); (S.S.)
- Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Venusberg-Campus 1, 53127 Bonn, Germany
| | - Niklas Hoormann
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.H.); (M.H.); (J.B.); (S.S.)
| | - Erik Kersten
- Max Planck Institute for Polymer Research (MPIP), Ackermannweg 10, 55128 Mainz, Germany; (E.K.); (K.P.); (F.R.W.)
| | - Keti Piradashvili
- Max Planck Institute for Polymer Research (MPIP), Ackermannweg 10, 55128 Mainz, Germany; (E.K.); (K.P.); (F.R.W.)
| | - Frederik R. Wurm
- Max Planck Institute for Polymer Research (MPIP), Ackermannweg 10, 55128 Mainz, Germany; (E.K.); (K.P.); (F.R.W.)
- Sustainable Polymer Chemistry, Department of Molecules and Materials, MESA+ Institute for Nanotechnology, Faculty of Science and Technology, Universiteit Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Martin Heller
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.H.); (M.H.); (J.B.); (S.S.)
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, 72076 Tübingen, Germany;
| | - Toni Anusic
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center, Obere Zahlbacher Str. 69, 55131 Mainz, Germany;
| | - Juergen Brieger
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.H.); (M.H.); (J.B.); (S.S.)
| | - Sebastian Strieth
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (N.H.); (M.H.); (J.B.); (S.S.)
- Department of Otorhinolaryngology, University Medical Center Bonn (UKB), Venusberg-Campus 1, 53127 Bonn, Germany
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15
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Gordiienko IM, Gubar OS, Sulik R, Kunakh T, Zlatskiy I, Zlatska A. Empty nose syndrome pathogenesis and cell-based biotechnology products as a new option for treatment. World J Stem Cells 2021; 13:1293-1306. [PMID: 34630863 PMCID: PMC8474723 DOI: 10.4252/wjsc.v13.i9.1293] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/29/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
Empty nose syndrome (ENS) is a rare complication that develops after partial or complete turbinectomy. The main feature of ENS is paradoxical nasal obstruction feeling despite objectively wide nasal airway. ENS pathogenesis is multifactorial and includes changes in laminar physiological airflow, disruption of mucosa functions and deficient neural sensation. This leads to the development of ENS symptomatology such as dyspnea, nasal dryness, nasal burning, nasal obstruction, feeling of suffocation and even comorbid psychiatric disorders that significantly impairs life quality. Specific effective treatment of ENS does not exist up to date. In this review we outline existing biomaterial for surgical reconstitution of nasal anatomy and discuss the perspective of stem cell-based technologies in ENS management. The main focus is directed to justification of rationality application of adult mesenchymal stem cells (MSCs) from different tissues origin and neural crest-derived stem cells (NCSCs) based on their intrinsic biological properties. MSCs transplantation may stimulate mucosa tissue regeneration via trophic factors secretion, direct transdifferentiation into epithelial cells and pronounced immunosuppressive effect. From the other hand, NCSCs based on their high neuroprotective properties may reconstitute nerve structure and functioning leading to normal sensation in ENS patients. We postulate that application of cell-based and tissue-engineered products can help to significantly improve ENS symptomatology only as complex approach aimed at reconstitution of nasal anatomy, recovery the nasal mucosa functionality and neural tissue sensation.
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Affiliation(s)
- Inna M Gordiienko
- Biotechnology Laboratory, Medical Company “Good Cells”, Kyiv 03115, Ukraine
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology NAS of Ukraine, Kyiv 03022, Ukraine
| | - Olga S Gubar
- Institute of Molecular Biology and Genetics NAS of Ukraine, Kyiv 03143, Ukraine
| | - Roman Sulik
- Biotechnology Laboratory, Medical Company “Good Cells”, Kyiv 03115, Ukraine
| | - Taras Kunakh
- Biotechnology Laboratory, Medical Company “Good Cells”, Kyiv 03115, Ukraine
| | - Igor Zlatskiy
- State Institute of Genetic and Regenerative Medicine, National Academy of Medical Sciences of Ukraine, Kyiv 04114, Ukraine
| | - Alona Zlatska
- Biotechnology Laboratory, Medical Company “Good Cells”, Kyiv 03115, Ukraine
- State Institute of Genetic and Regenerative Medicine, National Academy of Medical Sciences of Ukraine, Kyiv 04114, Ukraine
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16
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Ku JK, Lee KG, Ghim MS, Kim YK, Park SH, Park Y, Cho YS, Lee BK. Onlay-graft of 3D printed Kagome-structure PCL scaffold incorporated with rhBMP-2 based on hyaluronic acid hydrogel. Biomed Mater 2021; 16. [PMID: 34181586 DOI: 10.1088/1748-605x/ac0f47] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022]
Abstract
The onlay-graft, one of the most difficult graft conditions, is used for diverse clinical conditions, including plastic and dental surgery. The graft should withstand continuous pressure from overlying tissues and have excellent bone formation capability in a limited bone contact situation. We recently developed a 3D printed Kagome-structured polycaprolactone (PCL) scaffold that has a stronger mechanical property. This study evaluated the clinical feasibility of this scaffold for onlay-graft use. The value of the scaffold containing recombinant human bone morphogenetic protein-2 in a hyaluronate-based hydrogel (rhBMP-2/HA) to enhance bone regeneration was also assessed. 3D-printed Kagome-PCL scaffolds alone (n= 12, group I) or loaded with rhBMP-2/HA (n= 12, group II) were grafted using a rat calvarial onlay-graft model. Following sacrifice at 2, 4, and 8 weeks, all 3D-printed Kagome-PCL scaffolds were accurately positioned and firmly integrated to the recipient bone. Micro-computed tomography and histology analyses revealed a constant height of the scaffolds over time in all animals. New bone grew into the scaffolds in both groups, but with greater volume in group II. These results suggest the promising clinical feasibility of the 3D-printed Kagome-PCL scaffold for onlay-graft use and it could substitute the conventional onlay-graft in the plastic and dental reconstructive surgery in the near future.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.,Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gandnam-gu, Seoul 06273, Republic of Korea
| | - Kang-Gon Lee
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Min-Soo Ghim
- Department of Mechanical Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul University Bundang Hospital, 81, Saemaul-ro 117, Bundang-gu, Seongnam-si 13634, Republic of Korea
| | - Sang-Hyug Park
- Department of Biomedical Engineering, Pukyong National Universtiy, 45, Yongso-Ro, Nam-Gu, Busan, Republic of Korea
| | - Yongdoo Park
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea
| | - Young-Sam Cho
- Department of Mechanical Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea.,Department of Mechanical and Design Engineering, Wonkwang University, 460 Iksandae-ro, Iksan, Jeonbuk 54538, Republic of Korea
| | - Bu-Kyu Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.,Department of Oral and Maxillofacial Surgery, Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, College of Medicine, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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17
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Weems AC, Arno MC, Yu W, Huckstepp RTR, Dove AP. 4D polycarbonates via stereolithography as scaffolds for soft tissue repair. Nat Commun 2021; 12:3771. [PMID: 34226548 PMCID: PMC8257657 DOI: 10.1038/s41467-021-23956-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
3D printing has emerged as one of the most promising tools to overcome the processing and morphological limitations of traditional tissue engineering scaffold design. However, there is a need for improved minimally invasive, void-filling materials to provide mechanical support, biocompatibility, and surface erosion characteristics to ensure consistent tissue support during the healing process. Herein, soft, elastomeric aliphatic polycarbonate-based materials were designed to undergo photopolymerization into supportive soft tissue engineering scaffolds. The 4D nature of the printed scaffolds is manifested in their shape memory properties, which allows them to fill model soft tissue voids without deforming the surrounding material. In vivo, adipocyte lobules were found to infiltrate the surface-eroding scaffold within 2 months, and neovascularization was observed over the same time. Notably, reduced collagen capsule thickness indicates that these scaffolds are highly promising for adipose tissue engineering and repair. Shape memory scaffolds are needed for minimally invasive tissue repair and void filling. Here the authors report on the development of 4D printed polycarbonate-based scaffolds with surface degradation properties which fill voids without deforming tissue and allow for tissue ingrowth with reduced immune response.
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Affiliation(s)
- Andrew C Weems
- School of Chemistry, University of Birmingham, Birmingham, UK.
| | - Maria C Arno
- School of Chemistry, University of Birmingham, Birmingham, UK
| | - Wei Yu
- School of Chemistry, University of Birmingham, Birmingham, UK
| | | | - Andrew P Dove
- School of Chemistry, University of Birmingham, Birmingham, UK.
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18
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Vishwanath M, Janakiraman N, Steinbacher DM, Uribe F. Orthodontic and surgical management of a patient with severe mandibular deficiency and asymmetry with condylar hypoplasia using 3-dimensional surgical planning in combination with a modified surgery-first approach. Am J Orthod Dentofacial Orthop 2020; 158:426-442. [PMID: 32862937 DOI: 10.1016/j.ajodo.2019.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 10/23/2022]
Abstract
Progressive improvements in digital technology and surgical techniques have synergized the speed, predictability, and favorable outcomes for patients undergoing surgical-orthodontic treatment with handicapping dentofacial deformities. This case report will demonstrate the management of a patient with severe mandibular hypoplasia, condylar hypoplasia, and mandibular asymmetry. The dentofacial deformity, and consequently, the unaesthetic facial appearance, led to psychosocial stress, symptoms of excessive daytime sleepiness, and functional limitations, especially related to mandibular movements. A modified surgery-first approach was used, which was successfully performed using computer-assisted surgical planning. Postsurgical orthodontics was accomplished with the aid of temporary skeletal anchorage mini-plates. An additional alloplastic enhancement of the chin addressed the severe microgenia, which the osseous advancement could not achieve. This resulted in a total advancement of the pogonion by 26 mm yielding a remarkable improvement in the patient's facial esthetics. Furthermore, a considerable improvement in mandibular function and reduction in daytime sleepiness occurred. The severe malocclusion with a discrepancy index value of 47 was treated to a successful final occlusion in 21 months of treatment time.
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Affiliation(s)
- Meenakshi Vishwanath
- Department of Growth and Development, Orthodontic Section, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebr.
| | - Nandakumar Janakiraman
- Department of Orthodontics, University of Louisville School of Dentistry, Louisville, Ky
| | - Derek M Steinbacher
- Section of Plastic and Reconstructive Surgery, Yale University School of Medicine, New Haven, Conn
| | - Flavio Uribe
- Department of Craniofacial Sciences, Division of Orthodontics, University of Connecticut School of Dental Medicine, Farmington, Conn
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19
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Abar B, Alonso-Calleja A, Kelly A, Kelly C, Gall K, West JL. 3D printing of high-strength, porous, elastomeric structures to promote tissue integration of implants. J Biomed Mater Res A 2020; 109:54-63. [PMID: 32418348 DOI: 10.1002/jbm.a.37006] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/10/2020] [Accepted: 04/19/2020] [Indexed: 12/19/2022]
Abstract
Despite advances in biomaterials research, there is no ideal device for replacing weight-bearing soft tissues like menisci or intervertebral discs due to poor integration with tissues and mechanical property mismatch. Designing an implant with a soft and porous tissue-contacting structure using a material conducive to cell attachment and growth could potentially address these limitations. Polycarbonate urethane (PCU) is a soft and tough biocompatible material that can be 3D printed into porous structures with controlled pore sizes. Porous biomaterials of appropriate chemistries can support cell proliferation and tissue ingrowth, but their optimal design parameters remain unclear. To investigate this, porous PCU structures were 3D-printed in a crosshatch pattern with a range of in-plane pore sizes (0 to 800 μm) forming fully interconnected porous networks. Printed porous structures had ultimate tensile strengths ranging from 1.9 to 11.6 MPa, strains to failure ranging from 300 to 486%, Young's moduli ranging from 0.85 to 12.42 MPa, and porosity ranging from 13 to 71%. These porous networks can be loaded with hydrogels, such as collagen gels, to provide additional biological support for cells. Bare PCU structures and collagen-hydrogel-filled porous PCU support robust NIH/3T3 fibroblast cell line proliferation over 14 days for all pore sizes. Results highlight PCU's potential in the development of tissue-integrating medical implants.
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Affiliation(s)
- Bijan Abar
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | | | - Alexander Kelly
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | - Cambre Kelly
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | - Ken Gall
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | - Jennifer L West
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
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20
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Outcomes and complications associated with malar onlays: literature review and case series of 119 implants. Br J Oral Maxillofac Surg 2020; 58:1110-1115. [PMID: 32586690 DOI: 10.1016/j.bjoms.2020.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 06/03/2020] [Indexed: 02/03/2023]
Abstract
Alloplastic malar onlays have been used by surgeons to correct or enhance the midfacial skeleton for over 40 years. Case series have shown respectable results using different alloplastic materials in various maxillofacial subsites. However, these articles include small numbers of patients with limited follow up. We present a literature review specifically concentrating on porous polyethylene (Medpor, Stryker) and polyethyl ether ketone (PEEK) malar onlays. We illustrate the technique used by a single oral and maxillofacial surgeon for placement of 119 implants in 61 patients over a 14-year period, and show the results of this work with long-term follow up. A complication rate of 2.5% in this cohort was reported, with follow up of three years, demonstrating that this technique for midfacial correction is successful in both the short and the long term.
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21
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Landry M, Hankins M, Berkovic J, Nathan CA. Delayed Infection of Porous Polyethylene Implants After Oncologic Maxillectomy and Reconstruction: 2 Case Reports and Review of Literature. EAR, NOSE & THROAT JOURNAL 2020; 100:1023S-1026S. [PMID: 32538671 DOI: 10.1177/0145561320927525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Medpor porous polyethylene implants are commonly used for facial skeletal reconstruction due to reported biocompatibility, fibrovascularization, and durability. While uncommon, late implant infections are an important consideration. We report delayed infections in 2 patients after unilateral total oncologic maxillectomy and reconstruction using Medpor implants for an ossifying fibroma and squamous cell carcinoma, respectively. In the first patient, annual interval computed tomography (CT) scans showed no recurrence of tumor or inflammatory changes. The second was lost to follow-up after adjuvant chemoradiation 1 year after resection. Patients both presented with swelling, drainage, and erythema around the implant at a mean of 4.5 years following maxillectomy. Both failed several attempts at conservative treatment. Cultures of implants removed at a mean of 2.5 months after infection grew α-hemolytic Streptococcus in the first and multiple organisms in the second, showing that the potential for delayed infection should be considered years after reconstruction.
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Affiliation(s)
- Mark Landry
- Department of Otolaryngology/HNS at LSU Health Shreveport, LA, USA
| | - Miriam Hankins
- Department of Otolaryngology/HNS at LSU Health Shreveport, LA, USA
| | - Juraj Berkovic
- Kaiser Permanente in Panorama City, Los Angeles, CA, USA
| | - Cherie-Ann Nathan
- Department of Otolaryngology/HNS at LSU Health Shreveport, LA, USA.,Head and Neck Surgical Oncology at Feist-Weiller Cancer Center, Shreveport, LA, USA
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22
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Kim SG. Classification of the journal category "oral surgery" in the Scopus and the Science Citation Index Expanded: flaws and suggestions. J Korean Assoc Oral Maxillofac Surg 2019; 45:186-191. [PMID: 31508350 PMCID: PMC6728620 DOI: 10.5125/jkaoms.2019.45.4.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 01/29/2019] [Accepted: 01/29/2019] [Indexed: 12/29/2022] Open
Abstract
Objectives The aim of this study was to evaluate the journal category “oral surgery” in Scopus and in the Science Citation Index Expanded (SCIE). Materials and Methods The Journal of Oral and Maxillofacial Surgery (JOMS), The Journal of the Korean Association of Oral and Maxillofacial Surgeons (JKAOMS), and The Journal of Prosthodontic Research (JPR) were selected from the Scopus list of journals as oral surgery journals. Maxillofacial Plastic and Reconstructive Surgery (MPRS) was selected from PubMed as a Scopus oral surgery title. From these titles, 10 recently published articles were collected and used for reference analysis. Results The percentage of citations from oral surgery journals was 26.7%, 24.5%, and 40.1% for JKAOMS, MPRS, and JOMS, respectively. In total, 1.1% of JPR's citations were from oral surgery journals and significantly fewer from other journals (P<0.001). The percentage of citations from dentistry journals excluding oral surgery journals was 11.9%, 34.4%, and 15.8% for JKAOMS, MPRS, and JOMS, respectively. For JPR, 80.6% of citations were from dentistry journals and significantly more were from other journals (P<0.001). Conclusion Selected samples revealed that JPR is incorrectly classified as an oral surgery journal in Scopus. In addition, the scientific interaction among JKAOMS, MPRS, and JOMS was different to JPR in the reference analysis.
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Affiliation(s)
- Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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