title: Hydroxyapatite/Collagen Composite Is a Reliable Material for Malar Augmentation.
abstract: OBJECTIVE
  To evaluate the long-term results of cheekbone augmentation using porous hydroxyapatite granules mixed with microfibrillar collagen in a large group of patients.
  
  
  METHODS
  Four hundred thirty patients who underwent zygomatic augmentation and intermaxillary osteotomy were evaluated clinically, radiologically, and histologically.
  
  
  RESULTS
  Complications were found in 13 patients (1.56%). There were no relevant radiologic differences in prosthesis volume after 1 month (T1) or after 24 months (T2) in any patient; there were no clinically relevant differences in 110 patients after 36 months. At T1, the prosthesis had a granular structure and the granules had not migrated; at T2, the prosthesis was staunchly adhering to the underlying bone. Over time, the radiopacity of the material increased. Histologic results of 19 biopsy specimens obtained from 8 patients 2 years after the procedure showed prominent ossification with low inflammation, confirming new bone formation over time. According to the visual analog scale, the patients were generally satisfied with the aspects that were considered.
  
  
  CONCLUSIONS
  Hydroxyapatite and collagen composite used during malarplasty produced a successful outcome. Its main drawback is a learning curve that is longer than for more frequently used implantable biomaterials.
authors.affiliation: Associate Professor, Department of Surgery, Unit of Maxillofacial Surgery and Dentistry, University of Verona, Verona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Agostino
authors.affiliation: Associate Professor, Department of Surgery, Unit of Maxillofacial Surgery and Dentistry, University of Verona, Verona, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Trevisiol
authors.affiliation: Clinical Assistant, Department of Surgery, Unit of Maxillofacial Surgery and Dentistry, University of Verona, Verona, Italy. Electronic address: Vittorio_favero@yahoo.it.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Favero
authors.affiliation: Private Practice, Arnett and Gunson Facial Reconstruction, Santa Barbara, CA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gunson
authors.affiliation: Clinical Assistant, Department of Pathology and Diagnostics, University of Verona, Verona, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Pedica
authors.affiliation: Professor and Chief, Department of Surgery, Unit of Maxillofacial Surgery and Dentistry, University of Verona, Verona, Italy.
authors.forename: Pier Francesco
authors.initials: PF
authors.lastname: Nocini
authors.affiliation: Private Practice, Arnett and Gunson Facial Reconstruction, Santa Barbara, CA and Assistant Professor, Department of Oral and Maxillofacial Surgery, Loma Linda University, Loma Linda, CA.
authors.forename: G William
authors.initials: GW
authors.lastname: Arnett
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000627:therapeutic use*; D054893:Cone-Beam Computed Tomography; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D063166:Maxillary Osteotomy / Q000379:methods; D019931:Maxillofacial Prosthesis Implantation / Q000379:methods; D008875:Middle Aged; D057909:Orthognathic Surgery / Q000379:methods; D013518:Surgery, Plastic / Q000379:methods; D055815:Young Adult; D015050:Zygoma / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D003094:Collagen; D017886:Durapatite