Mimix hydroxyapatite cement use in the reconstruction of the craniofacial skeleton

Document Type

Article

Abstract

Reconstruction of the craniofacial skeleton has undergone a significant evolution during the past century. Initially, the use of autogenous bone grafts from various sites was the criterion standard. However, owing to donor site morbidity and lack of sufficient bone for large defects, surgeons have relied on various bone substitutes. Hydroxyapatite (HA) has served as an alternative to autogenous grafts, but questions regarding biocompatibility, risk of infection, and slow set times have hampered its acceptance. This article serves as a review of a single surgeon's experience using HA in the craniofacial skeleton. Eighteen patients receiving HA between March 2000 and November 2006 were observed. Sixteen underwent recontouring of skull-based bone defects, and 2 underwent recontouring for nasal and alveolar defects. The mean amount of HA used in each patient was 30.2 g. For large contour irregularities, the maximum thickness of HA used was 8 mm. The size of bone defects ameliorated averaged 4.8 cm(2). Complications occurred in 3 (16.7%) of 18 patients and included scalp hematoma and superficial cellulitis. In addition, 1 patient developed a facial abscess after placement along the alveolar floor, which necessitated removal. Hydroxyapatite represents a viable alternative to autogenous bone grafts when used in the correct manner. Hydroxyapatite should be used only for smaller defects or used in conjunction with absorbable plates when attempting to fill larger defects. Use of HA for nasal piriform augmentation or alveolar bone grafting should not be considered owing to problems with late infections.

Medical Subject Headings

Absorbable Implants; Adolescent; Adult; Child; Child, Preschool; Facial Bones (surgery); Female; Humans; Hydroxyapatites (therapeutic use); Male; Postoperative Complications; Plastic Surgery Procedures (methods); Treatment Outcome

Publication Date

11-1-2011

Publication Title

The Journal of craniofacial surgery

E-ISSN

1536-3732

Volume

22

Issue

6

First Page

2144

Last Page

7

PubMed ID

22067865

Digital Object Identifier (DOI)

10.1097/SCS.0b013e3182323ca8

Link to Full Text

Share

COinS