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Biocompatible Materials for Orbital Wall Reconstruction-An Overview. MATERIALS 2022; 15:ma15062183. [PMID: 35329635 PMCID: PMC8954765 DOI: 10.3390/ma15062183] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/27/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022]
Abstract
The reconstruction of an orbit after complex craniofacial fractures can be extremely demanding. For satisfactory functional and aesthetic results, it is necessary to restore the orbital walls and the craniofacial skeleton using various types of materials. The reconstruction materials can be divided into autografts (bone or cartilage tissue) or allografts (metals, ceramics, or plastic materials, and combinations of these materials). Over time, different types of materials have been used, considering characteristics such as their stability, biocompatibility, cost, safety, and intraoperative flexibility. Although the ideal material for orbital reconstruction could not be unanimously identified, much progress has been achieved in recent years. In this article, we summarise the advantages and disadvantages of each category of reconstruction materials. We also provide an update on improvements in material properties through various modern processing techniques. Good results in reconstructive surgery of the orbit require both material and technological innovations.
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Vatani M, Beigi MH, Ejeian F, Mottaghi A, Yadegari-Naeini A, Nasr-Esfahani MH. Cytotoxicity Evaluation of The Bioresorbable and Titanium Plates/Screws Used in Maxillofacial Surgery on Gingival Fibroblasts and Human Mesenchymal Bone Marrow Stem Cells. CELL JOURNAL 2019; 22:310-318. [PMID: 31863656 PMCID: PMC6947002 DOI: 10.22074/cellj.2020.6409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/08/2019] [Indexed: 12/02/2022]
Abstract
Objective Bioresorbable and titanium plates/screws are considered as a standard treatment for fixation of the bone
segments of craniofacial area and paying attention to their biocompatibility is an important issue along with other
aspects of application. The purpose of the study was to evaluate the cell viability of two types of plate and screw used
in maxillofacial surgeries in contact with gingival fibroblasts and bone marrow stem cells.
Materials and Methods In this experimental study after extraction and cultivation of cells from healthy human gingival
tissue and alveolar bone of jaw, cytotoxicity of device was evaluated. In direct contact method, samples had near
vicinity contact with the both cell lines and in indirect contact method, by-products released, like ions, from samples
after 8 weeks were used to assess cytotoxicity. Then cytotoxicity was evaluated on the 2nd, 4th and 6th day with MTS
tests and microscopy. The data were analyzed by one-way ANOVA and independent t tests.
Results There was a statistically significant difference between the German plate and screw and all the samples
studied on day 6 (P<0.05). Furthermore, a statistically significant difference was observed between both metal samples
and both bio-absorbable samples on day 6 and both cell lines (P<0.05). Comparisons between the two groups with
each other for both cell lines on the 6th day were statistically significant (P<0.05).
Conclusion Our results suggest that that cytotoxicity of biomaterial, from different brands, were not similar and some
of the biomaterial showed lower degree of toxicity compared to others and specialist using these products showed
be aware of this differences. Our investigation indicates more biocompatibility of bioresorbable plates and screws
compared to titanium. In addition our results suggest that biomaterials were not completely neutral.
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Affiliation(s)
- Masoud Vatani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Beigi
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Fatemeh Ejeian
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Ahmad Mottaghi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran. Electronic Address:
| | - Afshin Yadegari-Naeini
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Khorasgan Branch, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. Electronic Address:
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Shtin V, Novikov V, Chekalkin T, Gunther V, Marchenko E, Choynzonov E, Kang SB, Chang MJ, Kang JH, Obrosov A. Repair of Orbital Post-Traumatic Wall Defects by Custom-Made TiNi Mesh Endografts. J Funct Biomater 2019; 10:jfb10030027. [PMID: 31252637 PMCID: PMC6787735 DOI: 10.3390/jfb10030027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/12/2019] [Accepted: 06/24/2019] [Indexed: 02/01/2023] Open
Abstract
Repairs of orbital post-traumatic and extensive malignant defects remain a major surgical challenge, in view of follow-up outcomes. Incorrect surgical management of injured facial structures results in cosmetic, ophthalmic, and social aftereffects. A custom-made knitted TiNi-based mesh (KTNM) endograft was employed to overcome post-surgical complications and post-resected lesions of the orbital area. Preoperative high-resolution computed tomography (CT) imaging and CAD modelling were used to design the customized KTNM in each case. Twenty-five patients underwent surgery utilizing the suggested technique, from 2014 to 2019. In all documented cases, resolution of the ophthalmic malfunction was noted in the early period. Follow-up observation evidenced no relapsed enophthalmos, hypoglobus, or diplopia as late complications. The findings emanating from our clinical observations allow us to claim that the KTNM indicated a high level of biocompatibility. It is simply modified intraoperatively to attach any desired shape/size for implantation and can also be screw-fixed, providing a good supporting ability. The KTNM precisely renders orbitozygomatic outlines and orbital floor, thus recovering the anatomical structure, and is regarded as an attractive alternative to Ti-based meshes and plates. Additionally, we report one of the studied cases, where good functional and cosmetic outcomes have been achieved.
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Affiliation(s)
- Valentin Shtin
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Valeriy Novikov
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Timofey Chekalkin
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia.
- Kang and Park Medical Co., R&D Center, Ochang 28119, Korea.
| | - Victor Gunther
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia
| | - Ekaterina Marchenko
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia
| | - Evgeniy Choynzonov
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Seung Baik Kang
- SMG-SNU Boramae Medical Center, Seoul National University, College of Medicine, Seoul 07061, Korea
| | - Moon Jong Chang
- SMG-SNU Boramae Medical Center, Seoul National University, College of Medicine, Seoul 07061, Korea
| | - Ji Hoon Kang
- Kang and Park Medical Co., R&D Center, Ochang 28119, Korea
| | - Aleksei Obrosov
- Department of Physical Metallurgy and Materials Technology, Brandenburg University of Technology, 03044 Cottbus, Germany
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Pourdanesh F, Latifi N, Latifi F. Complications after craniofacial reconstruction with calcium phosphate cements: a case report and review of the literature. J Korean Assoc Oral Maxillofac Surg 2018; 44:207-211. [PMID: 30402411 PMCID: PMC6209695 DOI: 10.5125/jkaoms.2018.44.5.207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 11/27/2022] Open
Abstract
Among different graft materials for craniofacial reconstruction, calcium phosphate cements have the advantages of alloplastic grafts and wide use. The authors report a case of foreign body reaction following frontal reconstruction with JectOS (an injectable calcium orthophosphate cement; Kasios) and reviewed the literature on complications of this material after craniofacial reconstruction from 2002 to 2017. Complications were categorized into two groups: immunologic reactions (consisting of seroma collection, chronic sinus mucosa swelling, and foreign body reaction) and non-immune events (infection, fragmentation, and ejection). It is wise to use calcium phosphate-based material only in selected cases with small defects, and long-term follow-up is needed to observe their consequences.
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Affiliation(s)
- Fereydoun Pourdanesh
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noorahmad Latifi
- Department of Plastic and Reconstructive Surgery, Hazrate Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Latifi
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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De La Peña A, De La Peña-Brambila J, Pérez-De La Torre J, Ochoa M, Gallardo GJ. Low-cost customized cranioplasty using a 3D digital printing model: a case report. 3D Print Med 2018; 4:4. [PMID: 29782609 PMCID: PMC5954791 DOI: 10.1186/s41205-018-0026-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/22/2018] [Indexed: 11/21/2022] Open
Abstract
Background Cranial defects usually occur after trauma, neurosurgical procedures like decompressive craniotomy, tumour resections, infection and congenital defects. The purpose of cranial vault repair is to protect the underlying brain tissue, to reduce any localized pain and patient anxiety, and improve cranial aesthetics. Cranioplasty is a frequent neurosurgical procedure achieved with the aid of cranial prosthesis made from materials such as: titanium, autologous bone, ceramics and polymers. Prosthesis production is often costly and requires complex intraoperative processes. Implant customized manufacturing for craniopathies allows for a precise and anatomical reconstruction in a shorter operating time compared to other conventional techniques. We present a simple, low-cost method for prosthesis manufacturing that ensures surgical success. Case presentation Two patients with cranial defects are presented to describe the three-dimensional (3D) printing technique for cranial reconstruction. A digital prosthesis model is designed and manufactured with the aid of a 3D computed tomography. Both the data of large sized cranial defects and the prosthesis are transferred to a 3D printer to obtain a physical model in poly-lactic acid which is then used in a laboratory to cast the final customised prosthesis in polymethyl methacrylate (PMMA). Conclusions A precise compliance of the prosthesis to the osseous defect was achieved. At the 6 month postoperative follow-up no complications were observed i.e. rejection, toxicity, local or systemic infection, and the aesthetic change was very significant and satisfactory. Customized 3D PMMA prosthesis offers cost advantages, a great aesthetic result, reduced operating time and good biocompatibility.
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Affiliation(s)
- Abel De La Peña
- Plastic and Reconstructive Surgeon, Plastic Surgery Institute, Mexico City, Mexico
| | - Javier De La Peña-Brambila
- 2Maxillofacial Surgeon, PhD, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco Mexico
| | - Juan Pérez-De La Torre
- 3Plastic and Reconstructive Surgeon, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco Mexico
| | - Miguel Ochoa
- 4Neurosurgeon, Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, Jalisco Mexico
| | - Guillermo J Gallardo
- Plastic and Reconstructive Surgeon, Plastic Surgery Institute, Mexico City, Mexico
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Gao Y, Arron ST, Raymond AK. Exposed hardware in a patient with invasive keratinocyte carcinoma. JAAD Case Rep 2018; 4:101-103. [PMID: 29379861 PMCID: PMC5771727 DOI: 10.1016/j.jdcr.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yi Gao
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Sarah T Arron
- Department of Dermatology, University of California, San Francisco, California
| | - Amanda K Raymond
- Department of Dermatology, University of California, San Francisco, California
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Caballero M, Jones DC, Shan Z, Soleimani S, van Aalst JA. * Tissue Engineering Strategies to Improve Osteogenesis in the Juvenile Swine Alveolar Cleft Model. Tissue Eng Part C Methods 2017; 23:889-899. [PMID: 28747097 DOI: 10.1089/ten.tec.2017.0148] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Alveolar (gumline) clefts are the most common congenital bone defect in humans, affecting 1 in 700 live births. Treatment to repair these bony defects relies on autologous, cancellous bone transfer from the iliac crest. This harvest requires a second surgical site with increased surgical time associated with potential complications, while providing only limited cancellous bone. Improvements in treatment protocols that avoid these limitations would be beneficial to patients with clefts and other craniofacial bone defects. There have been steady advances in tissue-engineered (TE) solutions for long-bone defects and adult patients, but advances for the pediatric craniofacial skeleton have been slower to emerge. This study utilizes a previously established juvenile swine model with a surgically created, critical size alveolar defect to test the efficacy of umbilical cord (UC) mesenchymal stem cells (MSCs) treatments on nano-microfiber scaffolds. At 1 month after implanting our TE construct, mineralized tissue in the surgical gap was quantified through computed tomography (CT), and histology, and excised tissue was subjected to mechanical testing. Both undifferentiated and predifferentiated (toward an osteogenic lineage) UC MSCs generated bone within the cleft on a scale comparable to iliac crest cancellous bone, as evidenced by histology and CT scans. All of the pigs treated with scaffold/stem cell combinations had mineralized tissue within the defect, although without filling the entire defect. Several of the experimental animals exhibited poor and/or asymmetric maxillary growth 1 month after the initial surgery, especially if the surgical defect was located on the smaller side of an already asymmetric pig. Our results demonstrate that tissue engineering approaches using UC MSCs are a promising alternative for repair of the alveolar cleft. Data in the pig model demonstrate that implanted scaffolds are at least as good as the current gold standard treatment based on harvesting cancellous bone from the iliac crest, regardless of whether the cells seeded on the scaffold are precommitted to an osteogenic fate.
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Affiliation(s)
- Montserrat Caballero
- Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Donna C Jones
- Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Zhengyuan Shan
- Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - Sajjad Soleimani
- Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
| | - John A van Aalst
- Division of Plastic Surgery, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio
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Designing patient-specific 3D printed craniofacial implants using a novel topology optimization method. Med Biol Eng Comput 2015; 54:1123-35. [PMID: 26660897 DOI: 10.1007/s11517-015-1418-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
Large craniofacial defects require efficient bone replacements which should not only provide good aesthetics but also possess stable structural function. The proposed work uses a novel multiresolution topology optimization method to achieve the task. Using a compliance minimization objective, patient-specific bone replacement shapes can be designed for different clinical cases that ensure revival of efficient load transfer mechanisms in the mid-face. In this work, four clinical cases are introduced and their respective patient-specific designs are obtained using the proposed method. The optimized designs are then virtually inserted into the defect to visually inspect the viability of the design . Further, once the design is verified by the reconstructive surgeon, prototypes are fabricated using a 3D printer for validation. The robustness of the designs are mechanically tested by subjecting them to a physiological loading condition which mimics the masticatory activity. The full-field strain result through 3D image correlation and the finite element analysis implies that the solution can survive the maximum mastication of 120 lb. Also, the designs have the potential to restore the buttress system and provide the structural integrity. Using the topology optimization framework in designing the bone replacement shapes would deliver surgeons new alternatives for rather complicated mid-face reconstruction.
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