Craniofacial reconstruction with high-density porous polyethylene implants

Area of Science:

• Biomaterials Science
• Plastic Surgery
• Oral and Maxillofacial Surgery

Background:

• Facial skeleton deformities require reconstruction using autogenic or allogenic materials.
• Porous polyethylene is an established alloplastic material for maxillofacial reconstruction and augmentation.
• High-density porous polyethylene offers benefits such as tissue ingrowth, lack of capsule formation, and ease of fixation.

Purpose of the Study:

• To evaluate the efficacy and complications of high-density porous polyethylene implants in maxillofacial reconstruction.
• To identify risk factors associated with alloplastic implant use in the maxillofacial region.

Main Methods:

• Retrospective evaluation of 83 porous polyethylene implants in 71 patients undergoing facial reconstruction.
• Analysis of secondary interventions, including contour alignment and implant removal due to extrusion or infection.

Main Results:

• Seven patients (approximately 9.8%) required secondary interventions.
• Four interventions were for implant removal due to extrusion or infection, indicating potential risks.
• Placement without periosteal or fascial coverage increased the risk of implant exposure.

Conclusions:

• While high-density porous polyethylene is effective, careful surgical technique is crucial to minimize complications.
• Direct placement under the skin without adequate coverage elevates the risk of implant exposure.
• Autogenic grafts are recommended over alloplastic materials for specific reconstructions like nasal dorsum and microtia.