title: Bioactive glass-ceramics in facial skeleton contouring.
abstract: The removal of certain facial-bone defects is a prerequisite to restoration of function, stability, and appearance. Synthetic bone substitutes are beneficial in cases where other operative techniques would be an unacceptable burden for a patient. Satisfactory results can be achieved in one surgical intervention with low costs and low demand on technical equipment. Osteoconductive, biocompatible, non-resorbable glass-ceramic implants based on oxyfluoroapatite and wollastonite permit osteointegration--a direct physical and chemical bond between live bone tissue and the implant without formation of a fibrous capsule. They display better stress durability in simulated body fluid than hydroxyapatite implants do. This material was used for facial skeletal framework, contour restoration in 44 cases under conditions where other solutions were doubtful. Patients were observed for 24.8 months. Immediate healing occurred without any adverse reaction. The main problem was extrusion, observed in 20.45% cases over a 2-3 month period after the implantation. All cases, with one exception, were solved with a satisfactory final result by reoperation, implant size reduction, and increased soft tissue cover. This approach was found to be a suitable technique, especially for patients exhausted by prior incompetent treatment but still dissatisfied with their appearance. Successful reconstruction with a bone substitute may remarkably increase quality of life for affected persons and, at the same time, reduce surgery-related time and costs.
authors.affiliation: Dept. of Plastic Surgery, Praha, Czech Republic. marketa.duskova@lf3.cuni.cz
authors.forename: Markéta
authors.initials: M
authors.lastname: Dusková
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Smahel
authors.forename: Milos
authors.initials: M
authors.lastname: Vohradník
authors.forename: Miroslav
authors.initials: M
authors.lastname: Tvrdek
authors.forename: Jirí
authors.initials: J
authors.lastname: Mazánek
authors.forename: Jirí
authors.initials: J
authors.lastname: Kozák
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kot'ová
authors.forename: Tomás
authors.initials: T
authors.lastname: Strnadel
mesh_terms: D000293:Adolescent; D000328:Adult; D018786:Bone Substitutes / Q000627:therapeutic use*; D002516:Ceramics / Q000627:therapeutic use*; D005147:Facial Bones / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation
chemical_list: D018786:Bone Substitutes; C023506:Glass ceramics