A Novel Application of Calcium Phosphate-Based Bone Cement as an Adjunct Procedure in Adult Craniofacial Reconstruction

Craniomaxillofacial Trauma and Reconstruction

Marcus Wong¹  Vigneswaran Nallathamby¹  Samuel Ho¹  Huiwen Ng¹  Michelle Ho¹ 

[1] Plastic Surgery Section, Department of General Surgery, Tan Tock Seng Hospital, Singapore

关键词: Norian;    craniofacial resurfacing;    corrective osteotomy;    camouflage procedure;   

DOI  :  10.1055/s-0031-1293516

学科分类：口腔科学

来源: Thieme Medical Publishers, Inc.

【 摘 要 】

Secondary corrective osteotomy of malunited craniofacial fractures can be a challenging proposition. The exposure, extrusion, and palpability of the titanium implants used become a genuine concern especially in areas of relatively thin skin, such as the periorbital region. Restoring a satisfactory contour to the midface is another major task for the plastic surgeon. Bone cement used to reconstruct craniofacial defects has existed for many years. However, most applications have been as a substitute for autogenous bone grafts for defects less than 25 cm2. In this article, we present two cases of malunited facial fractures that underwent corrective osteotomy, during which we felt that despite the conventional osteotomy and reduction techniques, there was still either a small remnant step deformity or suboptimal contour smoothness due to prominence of the implants used. We thus used bone cement as a resurfacing medium over titanium implants to restore good malar contour and reduce the palpability and exposure rate of the titanium implants. We report good patient satisfaction with contour correction with no increase in wound infection rates or any delay in wound healing. There was initial chemosis associated with the use of the bone cement, which resolved in both patients within 3 to 4 weeks. Postoperative computed tomography showed some degree of osteointegration but no fraction of the bone cement. Calcium phosphate bone cement thus presents an attractive adjunctive method for midfacial contour resurfacing, when used in conjunction with conventional osteotomy procedures and as an onlay over prominent titanium implants.

【 授权许可】

Unknown