Clinical And Foundation Research Of Calvarial Bone Graft Combined With Alloplastic Materials For Calvarial Defect

Purpose:1. To observe the clinical effect of calvarial bone graft combined with alloplastic materials for complex calvarial defect, and analyse the advantage of the method of the surgery, and the problems that may exist.2. To evaluate the effect of the osteogenesis of coral hydroxyapatite as artificial bone scaffolds and study the effect of this new method. Using cranial bone graft combined with coral hydroxyapatite in miniature pigs calvarial defect, provide the necessary experimental basis for clinical application.Methods:1. Eight patients with complex calvarial defects underwent cranioplasty with porous polyethylene combined with split calvarial bone graft. Five patients with complex calvarial defects underwent cranioplasty with titanium plate combined with split calvarial bone graft. Follow-up visits were conducted for6to72months to monitor the patients.2. Three-month-old miniature pigs were used as experimental animals and were randomised into two groups. Experiment A:The osteotomy was performed on parietal bone and formation calvarial defect model, no repair. Experiment B:The osteotomy was performed on parietal bone and formation calvarial defect model, repaird by cranial bone graft combined with coral hydroxyapatite. Observation the osteogenesis and effect of this method by morphological, histological, radiological.Results:1. Significant improvements in the contour of the skulls as well as in the aesthetic appearance of all the patients were observed. Moreover, no serious complications, such as infections, exposure, removal of the implants, and contour or implant abnormalities were observed. Five cases displayed a transient extradural seroma collection, which was resolved through drainage and compression bandaging.2. The calvarial bone graft was replaced by new bone, the coral hydroxyapatite was absorbed and replaced by new bone. There are no significant differences in the new bone, and the defect is totally repaired by new bone.Conclusions:1. The results of this pilot study indicate that the combined use of porous polyethylene or titanium plate and split calvarial bone graft may be useful for cranial reconstruction in patients with complex cranial defects.2. Coral hydroxyapatite as artificial bone scaffolds can be absorbed and formed new bone. This new method of using calvarial bone graft combined with coral hydroxyapatite to covered calvarial defect in miniature pigs has well effect. This study provided a theoretical basis for clinical use of this new method.