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Gu L, Huang R, Ni N, Gu P, Fan X. Advances and Prospects in Materials for Craniofacial Bone Reconstruction. ACS Biomater Sci Eng 2023; 9:4462-4496. [PMID: 37470754 DOI: 10.1021/acsbiomaterials.3c00399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The craniofacial region is composed of 23 bones, which provide crucial function in keeping the normal position of brain and eyeballs, aesthetics of the craniofacial complex, facial movements, and visual function. Given the complex geometry and architecture, craniofacial bone defects not only affect the normal craniofacial structure but also may result in severe craniofacial dysfunction. Therefore, the exploration of rapid, precise, and effective reconstruction of craniofacial bone defects is urgent. Recently, developments in advanced bone tissue engineering bring new hope for the ideal reconstruction of the craniofacial bone defects. This report, presenting a first-time comprehensive review of recent advances of biomaterials in craniofacial bone tissue engineering, overviews the modification of traditional biomaterials and development of advanced biomaterials applying to craniofacial reconstruction. Challenges and perspectives of biomaterial development in craniofacial fields are discussed in the end.
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Affiliation(s)
- Li Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Rui Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ni Ni
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Ping Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - Xianqun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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Mims MM, Wang EW. Cost Analysis of Implants in the Surgical Repair of Orbital Floor Fractures. Ann Otol Rhinol Laryngol 2019; 129:456-461. [PMID: 31833378 DOI: 10.1177/0003489419894358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Options for the management of orbital floor fractures continue to evolve offering both potential advantages as well as higher costs. To date, the effect of implant choice on the cost associated with the repair of orbital floor fractures has not been studied. METHODS A retrospective review at a tertiary care, level I trauma center examining all adult, uncomplicated orbital floor fractures that underwent open reduction and internal fixation from 2013 to 2016. Patients with concurrent operative facial fractures were excluded. The main outcomes were overall cost of care from injury to last follow-up and operating room-related costs. Costs were determined using computerized records of charges as well as the hospital Charge Description Master. Kruksal-Wallis rank sum tests were used to analyze for differences between groups. RESULTS Twenty-eight patients fulfilled the inclusion criteria. Eight different stock, non-patient specific, implants were used for repair. The cost of individual types of implants ranged from $70.25 to $7 718.00. Total cost of care per patient across all implant types averaged $35 585.57 (range $25 586.26 to $49 985.74, P = .34). Operation-related charges accounted for the vast majority (94.4%) of the total cost of care. One complication occurred requiring operative re-positioning of the implant with an additional $13 042.41 in charges. CONCLUSIONS In the setting of uncomplicated orbital floor fractures, surgeons should select an implant that allows them to carry out the repair in a safe, timely fashion. Additional large-scale studies would help to further delineate cost differences.
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Affiliation(s)
- Mark M Mims
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
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Magro-Filho O, Goiato MC, Oliveira DTN, Martins LP, Salazar M, Medeiros RAD, Santos DMD. Evaluation of Patients' Satisfaction after Class III Orthognathic Surgery. J Clin Diagn Res 2015; 9:ZC23-7. [PMID: 26557610 DOI: 10.7860/jcdr/2015/14633.6587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/06/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Well-planned orthognathic surgery improves psychological health, aesthetics and function of patients. AIM The present study aimed to investigate patients' satisfaction after orthognathic surgery by means of a satisfaction questionnaire before and after surgery. MATERIALS AND METHODS A total of 29 patients was selected (17 women and 12 men), with a mean age of 28 years, randomly selected from a private clinic at Araçatuba - São Paulo by two investigators. Anamnesis and clinical examination were performed. Subjects with facial deformities submitted to orthodontic treatment before and after orthognathic surgery with a minimum post-surgery period of 6 months, answered a satisfaction questionnaire composed of 10 questions regarding dental and facial aesthetics. In this study, the maximum satisfaction score was 10. RESULTS Regarding aesthetics, two satisfaction parameters were investigated: dental and facial. For all indices, the average satisfaction was up to score 7. CONCLUSION According to the results, it can be concluded that orthognathic surgery has been an effective treatment for dentofacial deformities, aesthetics and functional problems, what was verified by pre and postoperative questionnaire application.
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Affiliation(s)
- Osvaldo Magro-Filho
- Faculty of Dentistry of Araçatuba, Department of Surgery and General Clinical, UNESP - Univ Estadual Paulista, Brazil
| | - Marcelo Coelho Goiato
- Faculty of Dentistry of Araçatuba, Department of Dental Materials and Prosthodontics, UNESP - Univ Estadual Paulista, Brazil
| | | | - Lidia Pimenta Martins
- Faculty of Dentistry of Araçatuba, Department of Orthodontics, UNESP - Univ Estadual Paulista, Brazil
| | - Marcio Salazar
- Faculty of Dentistry of Araçatuba, Department of Orthodontics, UNESP - Univ Estadual Paulista, Brazil
| | - Rodrigo Antonio De Medeiros
- Faculty of Dentistry of Araçatuba, Department of Dental Materials and Prosthodontics, UNESP - Univ Estadual Paulista, Brazil
| | - Daniela Micheline Dos Santos
- Faculty of Dentistry of Araçatuba, Department of Dental Materials and Prosthodontics, UNESP - Univ Estadual Paulista, Brazil
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Treatment of orbital blowout fracture using porous polyethylene with embedded titanium. J Craniofac Surg 2015; 26:569-72. [PMID: 25699530 DOI: 10.1097/scs.0000000000001407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The study was performed to evaluate the effectiveness and safety of porous polyethylene with embedded titanium in the repair of orbital blowout fracture. The study was designed as a prospective case series. Patients who were diagnosed with orbital blowout fracture from May 2012 to March 2013 were included in the study. A composite material of porous polyethylene and titanium mesh was used. Orbital volumes before and after surgery were measured, and the results of diplopia and ocular movement were recorded. The occurrence of diplopia was grouped and compared according to the time interval between injury and surgery. The incidence of other complications was also recorded. A total of 26 patients were involved in the study. The minimal follow-up time was 12 months. All surgeries were performed uneventfully. The orbital volume significantly decreased after the surgery, and the remission rate and the elimination rate of diplopia in 12 months were 85.7% and 47.6%, respectively. Postoperative diplopia was correlated with the time interval between injury and surgery. One patient presented with undercorrection of enophthalmos, and another patient presented with acute aggravation of diplopia and exophthalmos after surgery, which was resolved with treatment. In conclusion, porous polyethylene with embedded titanium was effective and safe in the repair of orbital blowout fracture, and studies with more subjects and longer follow-up period are recommended in future studies.
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Goiato MC, Santos MR, Monteiro BCZ, Moreno A, Bannwart LC, Filho AJV, Guiotti AM, Haddad MF, Pesqueira AA, Dos Santos DM. Electrical activity of the orbicularis muscles before and after installation of ocular prostheses. Int J Oral Maxillofac Surg 2015; 44:127-31. [PMID: 25457831 DOI: 10.1016/j.ijom.2014.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 07/21/2014] [Accepted: 09/19/2014] [Indexed: 11/16/2022]
Affiliation(s)
- M C Goiato
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil.
| | - M R Santos
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - B C Z Monteiro
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - A Moreno
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - L C Bannwart
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - A J V Filho
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - A M Guiotti
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - M F Haddad
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - A A Pesqueira
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
| | - D M Dos Santos
- Oral Oncology Centre, School of Dentistry of Araçatuba, UNESP, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil
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Tak KS, Jung MS, Lee BH, Kim JH, Ahn DK, Jeong HS, Park YK, Suh IS. Combination of absorbable mesh and demineralized bone matrix in orbital wall fracture for preventing herniation of orbit. J Craniofac Surg 2014; 25:e352-6. [PMID: 25006944 DOI: 10.1097/scs.0000000000000796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
After restoration of orbit wall fracture, preventing sequelae is important. An absorbable mesh is commonly used in orbit wall fracture, yet it has limitation due to orbit sagging when bony defect is larger than the moderate size (1 × 1 cm2). In this study, the authors present a satisfactory result in treating orbit wall fracture larger than the moderate size with a combination of absorbable mesh and demineralized bone matrix.From 2009 to 2012, 63 patients with bony defect larger than the moderate size, who were treated with a combination of absorbable mesh and demineralized bone matrix, were reviewed retrospectively. The site of bony defect, size, and applied amount of demineralized bone matrix were reviewed, and a 2-year follow-up was done. Facial computed tomography scans were checked preoperative, immediate postoperative, and 2-year postoperative.Among the 63 patients, there were 52 men and 11 women. Mean age was 33.3 years. The most common cause was blunt blow (35 cases); mean defect size was 13.36 × 12.82 mm2 in inferior wall fracture and 20.69 × 14.41 mm2 in medial wall fracture. There was no complication except for 3 cases of infraorbital nerve hypoesthesia. A 2-year follow-up computed tomography showed that the surgical site preserved bony formation without herniation. In treating moderate-sized bony defect in orbit wall fracture, absorbable mesh and demineralized bone matrix can maintain structural stability through good bony formation even after degradation of absorbable mesh.
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Affiliation(s)
- Kyoung Seok Tak
- From the *TN Plastic Surgery Clinic, Seoul, Korea; and †Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
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Abstract
Orbital floor injuries, alone or combination with other facial fractures, are one of the most commonly encountered midface fractures. Techniques for orbital reconstruction have migrated away from autogenous bone grafts to well-tolerated alloplasts, such as titanium and Medpor. Material for reconstructing the orbit can then be selected based on requirements of the defect matched to the mechanical properties of the material. Material selection is largely and ultimately dependent upon surgeon preference.
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[Orbitocutaneous fistula after orbital reconstruction]. HNO 2012; 61:344-6. [PMID: 22733279 DOI: 10.1007/s00106-012-2529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A 73-year old man presented with a lesion inferior to his left medial canthus with discharge and headache. Fifteen years previously, the patient had undergone reduction of an orbital fracture and reconstruction of the orbit with silicone. An orbitocutaneous fistula was found to originate from the implant which was displaced in the ethmoid, obstructing frontal sinus outflow. Symptoms disappeared after explantation of the implant, reconstruction of the orbit with a titanium plate and frontal sinus surgery. Although the use of silicone in facial trauma has declined, complications have to be expected even years after implantation.
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