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Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant

Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant. Maurice Mommaerts President European Association for Cranio-Maxillo-Facial Surgery Bruges, Belgium 7th Asian Pacific Craniofacial conference, Taipeh, Taiwan. Issues.

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Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant

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  1. Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial Surgery Bruges, Belgium 7th Asian Pacific Craniofacial conference, Taipeh, Taiwan

  2. Issues • Contour irregularities in corrective osteotomies In chin osteotomy In sagittal split osteotomy for mandibular advancement in skinny ladies • Post trauma & congenital defects Orbital region Temporal areas Localized midfacial deficiency in clefts and craniofacial syndromes • Residual asymmetries uncorrectable with osteotomies Mandibular border & lateral surface

  3. 2003-2008 caseload of 48 patients

  4. Combination Hydroxyapatite Pro Osteon (Interpore Cross) Fibrin glue Tisseel/Tissucol Bone paste Human cancellous bone Pro Osteon Implant 500 Blood clot Tisseel clot

  5. Sealant Purified fibrinogen (a protein) Purified thrombin (an enzyme) derived from human blood Human blood factor XIII Aprotinin, derived from cows' lungs Factor XIII strengthens blood clots by forming cross-links between strands of fibrin Aprotinin is a protein that inhibits the enzymes that break down blood clots Fibrin sealant (FS)

  6. Sealant Hemostasis Sealing Closing effect As of 2003, all fibrin sealants used are made from blood plasma taken from carefully screened donors and rigorously tested to eliminate hepatitis viruses, HIV-1, and parvovirus. Fibrin sealant (FS)

  7. Calcium hydroxylapatite A mineral Naturally occurring form of calcium apatite Ca5(PO4)3(OH 70% of bone is made up of HA Ability to integrate in bone structures & support bone ingrowth, without breaking down or dissolving (i.e it is bioactive) Granules (HA)

  8. Application mode 1

  9. Application mode 2

  10. Chin osteotomy - anterior text2 anterior step

  11. 1 day postop

  12. Chin osteotomy - lateral lateral step + autologous bone from chin ostectomy

  13. ½ y after correction of open bite and heavy chin

  14. ½ y after correction of open bite and heavy chin

  15. ½ y after correction of open bite and heavy chin

  16. Mandibular angle in asymmetries

  17. Mandibular angle in drag king

  18. 3 years postop

  19. In facial makeover

  20. Infraorbital augmentation

  21. Conclusion “clay” no infections rare tract extrusion long-term results

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