Skeletal volume enhancement: implants and osteotomies

Area of Science:

• Plastic Surgery
• Biomaterials Science
• Biotechnology

Background:

• Facial plastic surgeons address form and function, often requiring craniomaxillofacial skeletal augmentation.
• Alloplastic biomaterials and surgical techniques are essential for cosmetic and reconstructive procedures.

Purpose of the Study:

• Review available alloplastic biomaterials for facial volume enhancement.
• Discuss zygomatic sandwich osteotomy for malar augmentation.
• Describe applications of distraction osteogenesis in the craniomaxillofacial region.
• Provide an update on tissue engineering and computer modeling in facial reconstruction.

Main Methods:

• Review of current literature on alloplastic biomaterials.
• Discussion of surgical techniques including zygomatic sandwich osteotomy.
• Analysis of distraction osteogenesis applications.
• Overview of advancements in tissue engineering and computer modeling.

Main Results:

• High-porosity expanded polytetrafluoroethylene and porous polyethylene show good biointegration and biocompatibility.
• Hydroxyapatite cement may cause inflammatory reactions and implant exposure.
• Distraction osteogenesis applications are expanding, with a trend towards internal and biodegradable devices.
• Tissue engineering shows potential for autogenous bone generation, and computer modeling aids in custom facial prostheses fabrication.

Conclusions:

• Multiple options exist for skeletal volume enhancement: alloplastic implants, osteotomies, and distraction osteogenesis.
• Surgeons must individualize treatment based on patient needs and technique pros/cons.
• Technological advancements in biomaterials, hardware, modeling, and tissue engineering will enhance craniomaxillofacial restoration.