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Facial Skeletal Augmentation Using Hydroxyapatite Cement
Maisie L. Shindo, MD;
Peter D. Costantino, MD;
Craig D. Friedman, MD;
Lawrence C. Chow, PhD
Arch Otolaryngol Head Neck Surg. 1993;119(2):185-190.
Abstract
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• This study investigates the use of a new calcium phosphate cement, which sets to solid, microporous hydroxyapatite, for facial bone augmentation. In six dogs, the supraorbital ridges were augmented bilaterally with this hydroxyapatite cement. On one side, the hydroxyapatite cement was placed directly onto the bone within a subperiosteal pocket. On the opposite side, the cement was contained within a collagen membrane tubule and then inserted into a subperiosteal pocket. The use of collagen tubules facilitated easy, precise placement of the cement. All implants maintained their original augmented height throughout the duration of the study. They were well tolerated without extrusion or migration, and there was no significant sustained inflammatory response. Histologic studies, performed at 3, 6, and 9 months revealed that when the cement was placed directly onto bone, progressive replacement of the implant by bone (osseointegration of the hydroxyapatite with the underlying bone) without a loss of volume was observed. In contrast, when the cement-collagen tubule combination was inserted, primarily a fibrous union was noted. Despite such fibrous union, the hydroxyapatite-collagen implant solidly bonded to the underlying bone, and no implant resorption was observed. Hydroxyapatite cement can be used successfully for the experimental augmentation of the craniofacial skeleton and may be applicable for such uses in humans.
(Arch Otolaryngol Head Neck Surg. 1993;119:185-190)
Author Affiliations
From the Departments of Otolaryngology–Head and Neck Surgery, University of Southern California, Los Angeles (Dr Shindo), Wilford Hall, US Air Force Medical Center, San Antonio, Tex, and Loyola University Medical School, Chicago, Ill (Dr Costantino); the Section of Otolaryngology, Yale University, New Haven, Conn (Dr Friedman); and the American Dental Association Health Foundation, Paffenbarger Research Center, Gaithersburg, Md (Dr Chow).
Footnotes
Accepted for publication July 10, 1992.
Reprint requests to Healthcare Consultation Center, University of Southern California, 1510 San Pablo St, Suite 201, Los Angeles, CA 90033-4605 (Dr Shindo).
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