[Rapid setting calcium phosphate cement for craniomaxillofacial surgery. 6 years experience].
BACKGROUND
Long-term results using hydroxyapatite cement (Bone Source) for the reconstruction of the facial skeleton and the forehead are reported.


METHODS
The cement consists of 73% tetracalcium phosphate and 27% dicalcium phosphate. Using 0.25 M phosphoric acid instead of water, the primary setting time can be shortened from 20 to 5 min in an isothermic reaction. Twenty-two patients suffering from consequences of trauma, tumor-like lesions, or neoplasm as well as dysmorphia were treated.


RESULTS
Following implantation, the healing process proceeded in most cases without complications. Due to hematoma and seroma as well as infection, two implants were lost. Follow-up examinations could be performed in 19 of the 22 patients on a average 40 months after operation. Most patients had good clinical long-term results. X-ray-analysis showed some discrete resorption of the implants in six patients. The further course must be decided based on clinical relevance.


CONCLUSIONS
The hydroxyapatite cement used in this study evidenced good intraoperative handling, an excellent histologically proved biocompatibility, and good long-term stability in normal body fluid. Up to now we have limited its use to non-load-bearing applications in craniofacial surgery.
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Plastische Operationen, HELIOS-Klinikum Erfurt. jpiesold@erfurt.helios-kliniken.de
J-U
JU
Piesold
M
M
Merwald
K
K
Braxein
H
H
Pistner
D000293:Adolescent; D000328:Adult; D000368:Aged; D001843:Bone Cements / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D002648:Child; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D004338:Drug Combinations; D004954:Esthetics; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005359:Fibrous Dysplasia, Polyostotic / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D006882:Hydroxyapatites / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013515:Surgery, Oral / Q000379:methods*; D014057:Tomography, X-Ray Computed
D001843:Bone Cements; D018786:Bone Substitutes; D002130:Calcium Phosphates; D004338:Drug Combinations; D006882:Hydroxyapatites; C475044:hydroxyapatite cement