Norian craniofacial repair system: compatibility with resorbable and nonresorbable plating materials.
BACKGROUND
Choice of bone replacement materials is important when reconstructing large craniofacial defects. Hydroxyapatite cements are often used for such reconstructions. Recent advances in the development of these cements have produced locally applied, in situ hardening materials excellent for use in craniofacial defects. To date, there has been a paucity of data comparing the use of calcium phosphate cements in combination with titanium or resorbable plating systems and their combined biocompatibility. An experimental dog model was used to compare these systems.


METHODS
Two 4 x 4-cm calvarial defects were created in each of 18 mongrel dogs, and defects were reconstructed with calcium phosphate cement with either titanium or resorbable mesh sheets to evaluate their interaction. Specimens were harvested and evaluated histologically for the development of new bone formation at 3, 6, and 12 months.


RESULTS
At 3 months, no differences were noted in the amount of bone formed between titanium and resorbable plating. By 6 months, the resorbable mesh sheet showed delayed bone formation compared with the titanium mesh. At 12 months, bone formation over the resorbable mesh accelerated to be no different from the titanium mesh. Importantly, new bone formation was seen within the monocalcium phosphate cement Norian Craniofacial Repair System on a reliable basis, regardless of mesh plate used.


CONCLUSIONS
There are no long-term adverse effects with the use of Norian cement with either titanium or resorbable mesh. However, further studies need to be conducted to determine why there is an arrested healing phase between 3 and 6 months with the Norian cement and resorbable plating materials.
Genecov
David G
DG
Dallas, Texas; and West Chester, Pa. From the International Craniofacial Institute, Cleft Lip and Palate Treatment Center, Medical City; Synthes, Inc.; and Texas A&M University System Health Science Center, Baylor College of Dentistry.
Kremer
Michael
M
Agarwal
Rajiv
R
Salyer
Kenneth E
KE
Barcelo
C Raul
CR
Aberman
Harold M
HM
Opperman
Lynne A
LA
D000818:Animals; D001672:Biocompatible Materials; D001860:Bone Plates; D004285:Dogs; D008297:Male; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods*; D012886:Skull / Q000601:surgery*; D013997:Time Factors
D001672:Biocompatible Materials