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Updated: Sep 17, 2025
Biological Compatibility Profile on Biomaterials for Bone Regeneration
Published on: November 16, 2018
Calcium phosphate vs. autologous cranioplasty in a pediatric population
L L Verhoef1, B Gareb1, J M C van Dijk2
1University of Groningen, University Medical Center Groningen, Department of Oral & Maxillofacial Surgery, Groningen, the Netherlands.
Insights
For pediatric cranioplasty, alloplastic hydroxyapatite-beta-tricalcium phosphate (HA-βTCP) implants showed significantly better survival rates than autologous bone flaps. This suggests HA-βTCP (TricOs™) is a superior option for reducing implant failure in children.
Area of Science:
- Neurosurgery
- Biomaterials Science
- Pediatric Surgery
Background:
- Cranioplasty is essential for persistent skull defects from trauma, tumors, or surgery.
- Autologous bone flaps, while standard, risk complications like resorption in pediatric patients.
- Identifying optimal materials for pediatric cranioplasty is crucial.
Purpose of the Study:
- To compare the efficacy of alloplastic hydroxyapatite-beta-tricalcium phosphate (HA-βTCP) versus autologous cranioplasties in pediatric patients.
- To determine the ideal material for pediatric cranioplasty, focusing on long-term survival and complication rates.
Main Methods:
- Retrospective analysis of 22 pediatric cranioplasties (11 autologous, 11 alloplastic HA-βTCP) between 1995-2021.
- Comparison of implant survival times using Kaplan-Meier curves and log-rank test.
Main Results:
- Alloplastic HA-βTCP (TricOs™) had a 9.1% failure rate, significantly lower than autologous bone flaps (63.6%).
- Mean survival time was significantly longer for alloplastic HA-βTCP (67.61 months) compared to autologous cranioplasties (32.75 months) (p=0.035).
Conclusions:
- Alloplastic HA-βTCP (TricOs™) demonstrates superior survival rates compared to autologous bone in pediatric cranioplasty.
- HA-βTCP (TricOs™) may offer a better alternative for reducing implant failure and bone resorption in pediatric patients.
- Further research is recommended to validate these retrospective findings.
Background And Objective:
Persistent skull defects due to trauma, tumors, or neurosurgical procedures often necessitate cranioplasty. Autologous bone flaps are the gold standard but have a high risk of complications in pediatric cases, especially bone flap resorption. This study evaluated alloplastic HA-βTCP (TricOs™) versus autologous cranioplasties, aiming to identify the ideal material for pediatric cranioplasties.
Materials And Methods:
A retrospective analysis of cranioplasties in pediatric patients with large cranial defects operated between 1995 and 2021 was conducted. Survival times of autologous and alloplastic HA-βTCP (TricOs™) cranioplasties were compared using Kaplan-Meier curves and log-rank test.
Results:
The cohort included 22 cranioplasties (11 autologous, 11 alloplastic HA-βTCP (TricOs™)). Autologous cranioplasties demonstrated 63,6 % failure rate versus 9,1 % in the alloplastic group. Mean survival time was significantly longer for alloplastic - (67.61 ± 7.96 months (95 % CI [52.00; 83.21])) compared to autologous cranioplasties (32.75 ± 13.20 months (95 % CI [6.88; 58.61])) (p = 0.035).
Conclusion:
Alloplastic HA-βTCP (TricOs™) demonstrated a significantly longer survival time compared to autologous cranioplasties. The findings suggest that HA-βTCP (TricOs™) offers a superior alternative in reducing risk of implant failure, potentially addressing the challenges of bone flap resorption in a pediatric population. Additional studies are warranted to endorse these retrospective findings.
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