Porous block hydroxyapatite in orthognathic surgery

Area of Science:

• Biomaterials Science
• Oral and Maxillofacial Surgery
• Regenerative Medicine

Background:

• Autogenous bone grafts are traditionally used in orthognathic surgery to fill osteotomy gaps.
• Limitations of autogenous bone grafts include donor site morbidity and limited availability.
• Porous hydroxyapatite presents a potential alternative biomaterial for bone regeneration.

Purpose of the Study:

• To evaluate the efficacy and safety of porous hydroxyapatite blocks as a bone graft substitute in orthognathic surgery.
• To assess the osseous stability, integration, and complication rates associated with porous hydroxyapatite implants.
• To analyze the biological and biomechanical properties of porous hydroxyapatite in the context of orthognathic procedures.

Main Methods:

• Seventy-six patients undergoing various orthognathic surgical procedures received porous hydroxyapatite blocks in osteotomy gaps.
• Procedures included inferior maxillary repositioning, maxillary advancement, transverse maxillary expansions, and chin repositioning.
• Open biopsies were performed on 11 patients, and radiographic follow-ups were conducted at a mean of 16.3 months.

Main Results:

• Excellent osseous stability was observed in 76 patients.
• Twenty-one of 24 biopsy specimens showed osseous union with bone deposition within implant pores.
• Radiographic analysis indicated stable implant volume, density, and discreteness over time.
• Three patients experienced complications related to the implant.

Conclusions:

• Porous hydroxyapatite blocks demonstrate excellent osseous stability and integration in orthognathic surgery.
• The material acts as a feasible bone graft substitute, showing successful osseous union and pore infilling.
• Porous hydroxyapatite is a viable alternative to autogenous bone grafts, justifying its continued use in orthognathic procedures.