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Long-term clinical and experimental/surface analytical studies of carbon/carbon maxillofacial implants.

Szabó G, Barabás J, Bogdán S, Németh Z, Sebők B, Kiss G - Maxillofac Plast Reconstr Surg (2015)

Bottom Line: The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon).The composition of this layer is identical to the composition of the underlying carbon fibres.The surface morphology and the structure were not changed after 8 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University, Mária utca 52, Budapest, 1085 Hungary.

ABSTRACT

Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years.

Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one.

Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants.

Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.

No MeSH data available.


Related in: MedlinePlus

The bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net. a Hemifacial microsomia, 12 years after double rib-transplantation. b The Carbulat™ prefabricated plate screwed on the bone. c The patient before and 1 week after the surgery
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Fig3: The bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net. a Hemifacial microsomia, 12 years after double rib-transplantation. b The Carbulat™ prefabricated plate screwed on the bone. c The patient before and 1 week after the surgery

Mentions: Compact Carbulat™ was applied in 2 patients, and mandibular bone was supplemented with a Carbulat™ net in 8 cases. The Carbulat™ net was used for augmentation purposes in 2 cases. In 1 patient, the facial asymmetry was corrected with a 5 × 2.5 cm net 5 years after the exstirpation of a tumour affecting the mandible. In the other case (hemifacial microsomia), rib transplantation had already been performed on two occasions in order to supplement the ascending branch of the mandible. Then, 10 years later, when the patient was 18 years old, the bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net prepared in appropriate size. This was necessary as the patient did not agree to undergo further autologous bone transplantation (Fig. 3).Fig. 3


Long-term clinical and experimental/surface analytical studies of carbon/carbon maxillofacial implants.

Szabó G, Barabás J, Bogdán S, Németh Z, Sebők B, Kiss G - Maxillofac Plast Reconstr Surg (2015)

The bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net. a Hemifacial microsomia, 12 years after double rib-transplantation. b The Carbulat™ prefabricated plate screwed on the bone. c The patient before and 1 week after the surgery
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591193&req=5

Fig3: The bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net. a Hemifacial microsomia, 12 years after double rib-transplantation. b The Carbulat™ prefabricated plate screwed on the bone. c The patient before and 1 week after the surgery
Mentions: Compact Carbulat™ was applied in 2 patients, and mandibular bone was supplemented with a Carbulat™ net in 8 cases. The Carbulat™ net was used for augmentation purposes in 2 cases. In 1 patient, the facial asymmetry was corrected with a 5 × 2.5 cm net 5 years after the exstirpation of a tumour affecting the mandible. In the other case (hemifacial microsomia), rib transplantation had already been performed on two occasions in order to supplement the ascending branch of the mandible. Then, 10 years later, when the patient was 18 years old, the bone and soft part deficiency causing the persisting facial asymmetry was corrected with a Carbulat™ net prepared in appropriate size. This was necessary as the patient did not agree to undergo further autologous bone transplantation (Fig. 3).Fig. 3

Bottom Line: The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon).The composition of this layer is identical to the composition of the underlying carbon fibres.The surface morphology and the structure were not changed after 8 years.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University, Mária utca 52, Budapest, 1085 Hungary.

ABSTRACT

Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years.

Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one.

Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants.

Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.

No MeSH data available.


Related in: MedlinePlus