The use of titanium reinforced porous polyethylene implants for reconstruction of extended maxillary defects in pediatric patients: Report of three cases
Ourania SCHOINOHORITI, Nadia THEOLOGIE-LYGIDAKIS, Ioannis IATROU
University Department of Oral and Maxillofacial Surgery at the “P. & A. Kyriakou” Children’s Hospital (Head: Professor I. Iatrou), Dental School, National and Kapodistrian University of Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2015) 2, 71-81
SUMMARY: Titanium reinforced porous polyethylene implant is an alloplastic material with a porous structure, high tensile strength and volumetric stability that allows fibrovascularization and rapid integration.
Aim: To present 3 cases of paediatric patients where this material has been used for the reconstruction of maxil- lary defects.
The defects occurred following the resection of large benign tumors. They were reconstructed at one stage with appropriately contoured titanium reinforced polyethylene implants, fixated with titanium screws. The patients tolerated the procedure well, without any signs of infection or implant exposure during the follow-up period; the functional and cosmetic outcome has been satisfactory. Conclusions: Titanium reinforced porous polyethylene im- plants seem to provide a safe, simple and reliable option for primary reconstruction of extended maxillary defects in pediatric patients.
KEY WORDS: adolescents; biocompatible materials; children; maxillo-mandibular reconstruction; Medpor; max- illofacial prosthesis implantation
REFERENCES
Aldekhayel S, Aljaaly H, Fouda-Neel O, Shararah AW, Zaid WS, Gi- lardino M: Evolving trends in the management of orbital floor frac- tures. J Craniofac Surg 25: 258-261, 2014
Baj A, Spotti S, Marelli S, Beltramini GA, Giannì AB: Use of porous polyethylene for correcting defects of temporal region following transposition of temporalis myofascial flap. Acta Otorhinolaryngol Ital 29: 265-269, 2009
Cenzi R, Farina A, Zuccerino L, Carinci F: Clinical outcome of 285 Med- por grafts used for craniofacial reconstruction. J Craniofac Surg 16: 526-30, 2005
Eski M, Sengezer M, Turegun M, Deveci M, Isik S: Contour restoration of the secondary deformities of zygomaticoorbital fractures with porous polyethylene implant. J Craniofac Surg 18(3): 520-525, 2007
Farkas LG, Posnick JC, Hreczko TM, Pron GE: Growth patterns in the orbital region: a morphometric study. Cleft Palate Craniofac J 29: 315-318, 1992
Frodel JL, Seung L: The use of high-density polyethylene implants in facial deformities. Arch Otolaryngol Head Neck Surg 124: 1219- 1223, 1998
Garibaldi DC, Iliff NT, Grant MP, Merbs SL: Use of porous polyethyl- ene with embedded titanium in orbital reconstruction: a review of 106 patients. Ophthal Plast Reconstr Surg 23: 439-444, 2007
Goldsmith D, Horowitz A, Orentlicher G: Facial skeletal augmentation using custom facial implants. Atlas Oral Maxillofac Surg Clin North Am 20: 119-134, 2012
He D, Li Z, Shi W, Sun Y, Zhu H, Lin M, Shen G, Fan X: Orbitozygo- matic fractures with enophthalmos: analysis of 64 cases treated late. J Oral Maxillofac Surg 2012 70: 562-576, 2012
Iatrou I, Theologie-Lygidakis N, Tzerbos F, Schoinohoriti OK: Oro-facial tumours and tumour-like lesions in Greek children and adoles- cents: An 11-year retrospective study. J Craniomaxillofac Surg 41: 437-443, 2013
Menderes A, Baytekin C, Topcu A, Yilmaz M, Barutcu A: Craniofacial reconstruction with high-density porous polyethylene implants. J Craniofac Surg 15: 719-724, 2004
Nowinski D, Messo E, Hedlund A: Treatment of orbital fractures: eval- uation of surgical techniques and materials for reconstruction. J Craniofac Surg 21: 1033-1037, 2010
Park JY, Kim SG, Baik SM, Kim SY: Comparison of genioplasty using Medpor and osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109: e26-30, 2010
Ram H, Singh RK, Mohammad S, Gupta AK: Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction. J Maxillofac Oral Surg 9: 134-141, 2010
Rapidis AD, Day TA: The use of temporal polyethylene implant after temporalis myofascial flap transposition: clinical and radiographic results from its use in 21 patients. J Oral Maxillofac Surg 64(1): 12-22, 2006
Theologie-Lygidakis N, Iatrou I, Alexandridis C: Blow-out fractures in children: six years' experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103: 757-763, 2007
Wheeler J, Phillips J: Pediatric facial fractures and potential long-term growth disturbances. Craniomaxillofac Trauma Reconstr 4: 43-52, 2011
Xu JJ, Teng L, Jin XL, Ji Y, Lu JJ, Zhang B: Porous polyethylene implants in orbital blow-out fractures and enophthalmos reconstruction. J Craniofac Surg 20: 918-920, 2009
University Department of Oral and Maxillofacial Surgery at the “P. & A. Kyriakou” Children’s Hospital (Head: Professor I. Iatrou), Dental School, National and Kapodistrian University of Athens, Greece
Hellenic Archives of Oral & Maxillofacial Surgery (2015) 2, 71-81
SUMMARY: Titanium reinforced porous polyethylene implant is an alloplastic material with a porous structure, high tensile strength and volumetric stability that allows fibrovascularization and rapid integration.
Aim: To present 3 cases of paediatric patients where this material has been used for the reconstruction of maxil- lary defects.
The defects occurred following the resection of large benign tumors. They were reconstructed at one stage with appropriately contoured titanium reinforced polyethylene implants, fixated with titanium screws. The patients tolerated the procedure well, without any signs of infection or implant exposure during the follow-up period; the functional and cosmetic outcome has been satisfactory. Conclusions: Titanium reinforced porous polyethylene im- plants seem to provide a safe, simple and reliable option for primary reconstruction of extended maxillary defects in pediatric patients.
KEY WORDS: adolescents; biocompatible materials; children; maxillo-mandibular reconstruction; Medpor; max- illofacial prosthesis implantation
REFERENCES
Aldekhayel S, Aljaaly H, Fouda-Neel O, Shararah AW, Zaid WS, Gi- lardino M: Evolving trends in the management of orbital floor frac- tures. J Craniofac Surg 25: 258-261, 2014
Baj A, Spotti S, Marelli S, Beltramini GA, Giannì AB: Use of porous polyethylene for correcting defects of temporal region following transposition of temporalis myofascial flap. Acta Otorhinolaryngol Ital 29: 265-269, 2009
Cenzi R, Farina A, Zuccerino L, Carinci F: Clinical outcome of 285 Med- por grafts used for craniofacial reconstruction. J Craniofac Surg 16: 526-30, 2005
Eski M, Sengezer M, Turegun M, Deveci M, Isik S: Contour restoration of the secondary deformities of zygomaticoorbital fractures with porous polyethylene implant. J Craniofac Surg 18(3): 520-525, 2007
Farkas LG, Posnick JC, Hreczko TM, Pron GE: Growth patterns in the orbital region: a morphometric study. Cleft Palate Craniofac J 29: 315-318, 1992
Frodel JL, Seung L: The use of high-density polyethylene implants in facial deformities. Arch Otolaryngol Head Neck Surg 124: 1219- 1223, 1998
Garibaldi DC, Iliff NT, Grant MP, Merbs SL: Use of porous polyethyl- ene with embedded titanium in orbital reconstruction: a review of 106 patients. Ophthal Plast Reconstr Surg 23: 439-444, 2007
Goldsmith D, Horowitz A, Orentlicher G: Facial skeletal augmentation using custom facial implants. Atlas Oral Maxillofac Surg Clin North Am 20: 119-134, 2012
He D, Li Z, Shi W, Sun Y, Zhu H, Lin M, Shen G, Fan X: Orbitozygo- matic fractures with enophthalmos: analysis of 64 cases treated late. J Oral Maxillofac Surg 2012 70: 562-576, 2012
Iatrou I, Theologie-Lygidakis N, Tzerbos F, Schoinohoriti OK: Oro-facial tumours and tumour-like lesions in Greek children and adoles- cents: An 11-year retrospective study. J Craniomaxillofac Surg 41: 437-443, 2013
Menderes A, Baytekin C, Topcu A, Yilmaz M, Barutcu A: Craniofacial reconstruction with high-density porous polyethylene implants. J Craniofac Surg 15: 719-724, 2004
Nowinski D, Messo E, Hedlund A: Treatment of orbital fractures: eval- uation of surgical techniques and materials for reconstruction. J Craniofac Surg 21: 1033-1037, 2010
Park JY, Kim SG, Baik SM, Kim SY: Comparison of genioplasty using Medpor and osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109: e26-30, 2010
Ram H, Singh RK, Mohammad S, Gupta AK: Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction. J Maxillofac Oral Surg 9: 134-141, 2010
Rapidis AD, Day TA: The use of temporal polyethylene implant after temporalis myofascial flap transposition: clinical and radiographic results from its use in 21 patients. J Oral Maxillofac Surg 64(1): 12-22, 2006
Theologie-Lygidakis N, Iatrou I, Alexandridis C: Blow-out fractures in children: six years' experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103: 757-763, 2007
Wheeler J, Phillips J: Pediatric facial fractures and potential long-term growth disturbances. Craniomaxillofac Trauma Reconstr 4: 43-52, 2011
Xu JJ, Teng L, Jin XL, Ji Y, Lu JJ, Zhang B: Porous polyethylene implants in orbital blow-out fractures and enophthalmos reconstruction. J Craniofac Surg 20: 918-920, 2009
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