Titanium Mesh Implants - Alternative for Cranial Bone Defects

2017 ◽  
Vol 752 ◽  
pp. 105-110
Author(s):  
Dan Mihai Teleanu ◽  
Alexandru Cristescu ◽  
Stefan Bogaciu ◽  
Raluca Ioana Teleanu ◽  
Alexandru Vlad Ciurea
Keyword(s):  
Bone Defect ◽  
Operating Time ◽  
Functional Results ◽  
Bone Defects ◽  
Cranial Bone ◽  
Titanium Mesh ◽  
Calvarial Bone ◽  
The Aesthetic ◽  
Reliable Solution ◽  
Mesh Implant

Calvarial bone defects are due to cranial bone removal at the end of the surgery (decompressive craniectomy), either because of bone involvement of the tumor or as a method to relieve intracranial pressure caused by important cerebral edema secondary to large tumors or traumas. With the progress of biomedical technology, new materials are available for use by surgeons. The titanium mesh implant is a plating platform with a matrix design and MRI compatibility that can be easily shaped, cut, and bent by the surgeon according to the bone defect. It is locked in place by several screws tapped into the bone. Although may different type of materials are currently available there is no consensus for the best method to be used. The aim of this study was to report our experience with titanium mesh implants for cranial repair and reconstruction of bone anatomy.Twenty four patients with decompressive craniectomies that required reconstruction of the calvarial bone defect for which a titanium mesh cranioplasty was used, operated in our Neurosurgery Department between January 2013 and April 2016 where included in this retrospective study. Of the 24 patients, only one had a localized infection complication for which the patient was re-operated and the implant removed with no other complications. No other neurological, infectious and functional complications were observed during or after surgery. All other patients had excellent anatomic and functional results with a positive feedback for the aesthetic aspects of the implant. The use of these bio-compatible materials is a viable, safe and reliable solution for the management of cranial bone defects offering the surgeon a large array of options for the benefit of the patient. It has a proven cost-effectiveness when compared to other customized prosthetics with the same outcomes. The MRI compatibility was proven very useful, especially for neoplasm patients who required frequent cranial imaging follow-ups, and reduced operating time was particularly beneficial to elderly patients.

Trifocal versus bifocal bone transport in treatment of long segmental tibial bone defects

2019 ◽  
Vol 101-B (2) ◽  
pp. 162-169 ◽  
Author(s):  
M. A. Catagni ◽  
W. Azzam ◽  
F. Guerreschi ◽  
L. Lovisetti ◽  
P. Poli ◽  
...  
Keyword(s):  
Bone Defect ◽  
Treatment Time ◽  
Operating Time ◽  
Functional Results ◽  
Bone Defects ◽  
Bone Transport ◽  
Fixation Time ◽  
Tibial Bone ◽  
Transport Distance ◽  
The Difference

Aims Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. Patients and Methods A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54). Results The size of the bone defect was significantly longer (p = 0.005), the number of previous operations was significantly higher (p < 0.001), the operating time was significantly longer (p < 0.001), and the bone transport distance was significantly increased (p = 0.017) in the TFT group. However, the external fixation time (p < 0.001), the healing index (p < 0.001), the number of additional procedures (p = 0.013), and the number of true complications (p < 0.001) were significantly reduced in this group. Both groups achieved highly satisfactory bone and functional results. Conclusion TFT can significantly reduce the treatment time, the number of additional surgical procedures, and true complications compared with BFT in the treatment of long segmental tibial bone defects.

Guided Bone Regeneration in Calvarial Bone Defects Using Polytetrafluoroethylene Membranes

1995 ◽  
Vol 32 (4) ◽  
pp. 311-317 ◽  
Author(s):  
Carles Bosch ◽  
Birte Melsen ◽  
Karin Vargervik
Keyword(s):  
Bone Regeneration ◽  
Bone Defect ◽  
Dura Mater ◽  
Bone Defects ◽  
Guided Bone Regeneration ◽  
Parietal Bone ◽  
Bony Defect ◽  
Calvarial Bone ◽  
Double Membrane ◽  
Single Membrane

Guided bone regeneration is defined as controlled stimulation of new bone formation in a bony defect, either by osteogenesis, osteoinduction, or osteoconduction, re-establishing both structural and functional characteristics. Bony defects may be found as a result of congenital anomalies, trauma, neoplasms, or infectious conditions. Such conditions are often associated with severe functional and esthetic problems. Corrective treatment is often complicated by limitations in tissue adaptations. The aim of the investigation was to compare histologically the amount of bone formed in an experimentally created parietal bone defect protected with one or two polytetrafluoroethylene membranes with a contralateral control defect. A bony defect was created bilaterally in the parietal bone lateral to the sagittal suture in 29 6-month-old male Wistar rats. The animals were divided into two groups: (1) In the double membrane group (n=9), the left experimental bone defect was protected by an outer polytetrafluoroethylene membrane under the periosteum and parietal muscles and an inner membrane between the dura mater and the parietal bone. (2) In the single membrane group (n=20), only the outer membrane was placed. The right defect was not covered with any membrane and served as control. The animals were killed after 30 days. None of the control defects demonstrated complete or partial bone regeneration. In the single membrane group, the experimental site did not regenerate in 15 animals, partially in four, and completely in one. In the double membrane group, six of the experimental defects had complete closure with bone, two had partial closure, and one no closure. The use of two membranes protecting the bone edges of the parietal defect from the overlying tissues and underlying brain enhanced bone regeneration in experimental calvarial bone defects. The biologic role of the dura mater may not be of critical importance in new bone regeneration in these calvarial bone defects.

scholarly journals The Experience of Using Various Modalities For Orbital Floor Fracture Reconstruction

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Pujisriyani Prawoto ◽  
Siti Handayani ◽  
Kristaninta Bangun
Keyword(s):  
Bone Graft ◽  
Case Series ◽  
Orbital Floor ◽  
Titanium Mesh ◽  
Calvarial Bone ◽  
Absorbable Mesh ◽  
Orbital Floor Reconstruction ◽  
The Aesthetic ◽  
The Cost ◽  
Diced Cartilage

Background: Fractures of the orbital floor require surgical intervention in group of patients with cosmetic problems and/or vertical diplopia. The surgical management of these patients provides a great challenge to the surgeon. A variety of implant materials have been used to recreate normal bony orbital dimension or supplement deficient orbital volume which include alloplastic or autogenous materials. The purpose of this case series was to assess the aesthetic and functional outcome of orbital floor reconstruction performed with calvarial bone graft, titanium mesh, absorbable mesh and “Turkish Delight” diced cartilage graft.Patients and Methods: From 2006-2010, we treated eight patients with orbital blowout fracture using various modalities. We used titanium mesh, absorbable mesh, calvarial bone graft and “Turkish delight” diced cartilage. These various modalities were chosen based on clinical examination, patient satisfaction, radiographic investigations and the cost on managing patient.Result: Calvarial bone graft were performed in two patient, “Turkish delight” diced cartilage in one patient, absorbable mesh in one patient, and titanium mesh in four patient. All patients had satisfactory result with adequate volume correction and reduction in vertical diplopia.Summary: All four materials, calvarial graft, titanium mesh, absorbable mesh, and “Turkish delight” diced cartilage graft have the potential to be useful reconstructive materials in orbital floor blowout fractures based on holistic consideration.

scholarly journals A Narrative Review of Cell-Based Approaches for Cranial Bone Regeneration

Pharmaceutics ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 132
Author(s):  
Maria I. Falguera Uceda ◽  
Silvia Sánchez-Casanova ◽  
Clara Escudero-Duch ◽  
Nuria Vilaboa
Keyword(s):  
Bone Defects ◽  
Cranial Bone ◽  
Structural Failure ◽  
Preclinical Research ◽  
Calvarial Bone ◽  
Promising Alternative ◽  
Gene Switches ◽  
Therapeutic Molecules ◽  
Autologous Bone Grafts ◽  
Repair Techniques

Current cranial repair techniques combine the use of autologous bone grafts and biomaterials. In addition to their association with harvesting morbidity, autografts are often limited by insufficient quantity of bone stock. Biomaterials lead to better outcomes, but their effectiveness is often compromised by the unpredictable lack of integration and structural failure. Bone tissue engineering offers the promising alternative of generating constructs composed of instructive biomaterials including cells or cell-secreted products, which could enhance the outcome of reconstructive treatments. This review focuses on cell-based approaches with potential to regenerate calvarial bone defects, including human studies and preclinical research. Further, we discuss strategies to deliver extracellular matrix, conditioned media and extracellular vesicles derived from cell cultures. Recent advances in 3D printing and bioprinting techniques that appear to be promising for cranial reconstruction are also discussed. Finally, we review cell-based gene therapy approaches, covering both unregulated and regulated gene switches that can create spatiotemporal patterns of transgenic therapeutic molecules. In summary, this review provides an overview of the current developments in cell-based strategies with potential to enhance the surgical armamentarium for regenerating cranial vault defects.

scholarly journals Novel Piston Technique Versus Ilizarov Technique for The Repair of Bone Defect After Lower Limb Infection

2021 ◽  
Author(s):  
Jiafei Du ◽  
Zifei Yin ◽  
Pengfei Cheng ◽  
Pei Han ◽  
Hao Shen
Keyword(s):  
Bone Defect ◽  
Bone Healing ◽  
Lower Limb ◽  
Functional Results ◽  
Bone Defects ◽  
Ilizarov Technique ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background We described the use of a novel Piston technique versus Ilizarov technique to compare the effectiveness and complications for the repair of bone defect after lower limb infection. Patients and methods: We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. They were 38 males and 3 females with a mean age of 43.41 (range 12 to 69 years). The infected bone defects involved 36 tibias and 5 femurs. Piston technique (PT, group A) was used in 12 patients and Ilizarov technique (IT, group B) in 29 ones. The mean duration of follow-up was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate the bone healing and functional recovery. Results Complete eradication of infection and union of docking sites were accomplished well in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between group A and B (p = 0.558) [excellent (9 vs. 19), good (3 vs.10)]; group A showed better functional outcomes than group B (p < 0.05) [excellent (7 vs. 6), good (4 vs. 12), fair (0 vs. 10) and poor (1 vs. 1)]. Pain was complained most during follow-up and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8) and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be obtained by using both PT and IT, while PT had better functional results, lower EFI and allowed early removal of the external fixation. We have found that this novel Piston technique can improve the comfort of patients, reduce the incidence of complications, and provide a rapid and convenient rehabilitation.

scholarly journals The Co-Culture of ASCs and EPCs Promotes Vascularized Bone Regeneration in Critical-Sized Bone Defects of Cranial Bone in Rats

2020 ◽  
Author(s):  
yuanjia he ◽  
Shuang Lin ◽  
Qiang Ao ◽  
Xiaoning He
Keyword(s):  
Bone Regeneration ◽  
Bone Tissue ◽  
Bone Defect ◽  
Culture System ◽  
Donor Site ◽  
Bone Defects ◽  
Cranial Bone ◽  
Vascularized Bone

Abstract Background: The repair of critical-sized bone defect represents a challenging problem in bone tissue engineering. To address the most important problem in bone defect repair, namely insufficient blood supply, this study aimed to find a method that can promote the formation of vascularized bone tissue.Method The phenotypes of ASCs and EPCs were identified respectively, and ASCs/EPCs were co-cultured in vitro to detect the expression of osteogenic and angiogenic genes. Furthermore, the co-culture system combined with scaffold material was used to repair the critical-sized bone defects of the cranial bone in rats.Results The co-culture of ASCs/EPCs could increase osteogenesis and angiogenesis-related gene expression in vitro. The results of in vivo animal experiments demonstrated that the ASCs/EPCs group could promote bone regeneration and vascularization in the meantime and, then significantly accelerate the repair of critical-sized bone defects.Conclusion It is feasible to replace traditional single seed cells with ASCs/EPCs co-culture system for vascularized bone regeneration. This system could ultimately enable clinicians to better repair the defect of craniofacial bone and avoid donor site morbidity.

scholarly journals The Co-Culture of ASCs and EPCs Promotes Vascularized Bone Regeneration in Critical-Sized Bone Defects of Cranial Bone in Rats

2020 ◽  
Author(s):  
yuanjia he ◽  
Shuang Lin ◽  
Qiang Ao ◽  
Xiaoning He
Keyword(s):  
Bone Regeneration ◽  
Bone Tissue ◽  
Bone Defect ◽  
Culture System ◽  
Donor Site ◽  
Bone Defects ◽  
Cranial Bone ◽  
Vascularized Bone

Abstract Background: The repair of critical-sized bone defect represents a challenging problem in bone tissue engineering. To address the most important problem in bone defect repair, namely insufficient blood supply, this study aimed to find a method that can promote the formation of vascularized bone tissue.Method The phenotypes of ASCs and EPCs were identified respectively, and ASCs/EPCs were co-cultured in vitro to detect the expression of osteogenic and angiogenic genes. Furthermore, the co-culture system combined with scaffold material was used to repair the critical-sized bone defects of the cranial bone in rats.Results The co-culture of ASCs/EPCs could increase osteogenesis and angiogenesis-related gene expression in vitro. The results of in vivo animal experiments demonstrated that the ASCs/EPCs group could promote bone regeneration and vascularization in the meantime and, then significantly accelerate the repair of critical-sized bone defects.Conclusion It is feasible to replace traditional single seed cells with ASCs/EPCs co-culture system for vascularized bone regeneration. This system could ultimately enable clinicians to better repair the defect of craniofacial bone and avoid donor site morbidity.

ALLOGRAFT BONE APPLICATION IN THE RAT CALVARIAL BONE DEFECT MODEL: A HISTOPATHOLOGICAL STUDY

2021 ◽  
pp. 22-24
Author(s):  
Büşra Deveci ◽  
Ahmet Dağ ◽  
Firat Asir ◽  
Ebru Gökalp Özkorkmaz ◽  
Engin Deveci
Keyword(s):  
Bone Defect ◽  
Bone Matrix ◽  
Scar Tissue ◽  
Bone Defects ◽  
Defect Group ◽  
Male Rats ◽  
Histopathological Study ◽  
Defect Model ◽  
Calvarial Bone ◽  
Calvarial Bone Defect

Trauma, neoplasms, infections, and congenital anomalies may be the reason for the calvarial bone defects. For eliminating bone defects in the cranial region to stimulate bone regeneration different graft types have been tried. In our study, we aimed to investigate the effects of allograft application in the rat calvarial bone defect model. For this purpose, 14 Wistar male rats were determined; defect (n=7) and defect + graft (n=7) groups. . The frontal bone was opened and a circular full thickness bone defect (5 mm) was created in the midline. Allograft material was placed in the defect area. All animals were sacriced after 28 days and the calvarial bones were followed up for routine histologic preparations. Sections were stained with H-E and scoring for histopathological parameters (inammation, brosis, osteoclast number, osteoblast number, osteocyte number, matrix formation, new bone trabecular diameter). In our study, inammation, brosis and osteoclast numbers decreased in the defect + graft group compared to the defect group, and osteocyte, osteoblast, matrix formation and bone trabecular diameter has increased signicantly. Histopathological evaluation revealed scar tissue, increased mononuclear cell inltration, and necrosis in the defect group. In the defect + graft group, an increase in collagen ber, a decrease in inammatory cells, an increase in osteoblast cells and bone matrix were observed. As a result, allograft application has been found to support new bone formation in the calvarial defect model by creating an osteoinductive and osteoconductive effect.

Sign in / Sign up

Export Citation Format

Share Document