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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 Carbulat™ plate had to be removed because of tumour recurrence. a X-ray picture of a huge osteosarcoma of the mandible. Very characteristic sclerotizing form. b Carbulat™ and titanium plate reconstruction. c 8 months after the first surgery the relapsed tumour (CT picture). d After removal the relapsed tumour the Carbulat plate. It is visible that the Carbulat™ plate integrated extremely well into the tissues
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Fig4: The Carbulat™ plate had to be removed because of tumour recurrence. a X-ray picture of a huge osteosarcoma of the mandible. Very characteristic sclerotizing form. b Carbulat™ and titanium plate reconstruction. c 8 months after the first surgery the relapsed tumour (CT picture). d After removal the relapsed tumour the Carbulat plate. It is visible that the Carbulat™ plate integrated extremely well into the tissues

Mentions: In those cases when the Carbulat™ plate had to be removed because of tumour recurrence or in a planned manner because of the later autologous bone transplantation, it was seen that the Carbulat™ had integrated extremely well into the tissues (Fig. 4). It was also visible that black carbon particles had migrated into the soft parts surrounding the plate. Inflammatory and histological changes of any other type could not be discerned around the fine particles either clinically or histologically. In one case, autologous bone transplantation was performed after more than 8 years. However, in that case too there were no visible changes around the implant apart from the black discolouration mentioned above. Histological examinations were performed on the material containing the carbon particles. The histologist’s report contained the following finding: “..... In the deeper regions, scar connective tissue can be seen, in which a foreign body is to be found in places, in the form of small black particles. Individual lymphocytes occur in the vicinity of these particles, but no appreciable inflammatory changes are visible, and no giant cell or granuloma formation can be observed”.Fig. 4


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 Carbulat™ plate had to be removed because of tumour recurrence. a X-ray picture of a huge osteosarcoma of the mandible. Very characteristic sclerotizing form. b Carbulat™ and titanium plate reconstruction. c 8 months after the first surgery the relapsed tumour (CT picture). d After removal the relapsed tumour the Carbulat plate. It is visible that the Carbulat™ plate integrated extremely well into the tissues
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig4: The Carbulat™ plate had to be removed because of tumour recurrence. a X-ray picture of a huge osteosarcoma of the mandible. Very characteristic sclerotizing form. b Carbulat™ and titanium plate reconstruction. c 8 months after the first surgery the relapsed tumour (CT picture). d After removal the relapsed tumour the Carbulat plate. It is visible that the Carbulat™ plate integrated extremely well into the tissues
Mentions: In those cases when the Carbulat™ plate had to be removed because of tumour recurrence or in a planned manner because of the later autologous bone transplantation, it was seen that the Carbulat™ had integrated extremely well into the tissues (Fig. 4). It was also visible that black carbon particles had migrated into the soft parts surrounding the plate. Inflammatory and histological changes of any other type could not be discerned around the fine particles either clinically or histologically. In one case, autologous bone transplantation was performed after more than 8 years. However, in that case too there were no visible changes around the implant apart from the black discolouration mentioned above. Histological examinations were performed on the material containing the carbon particles. The histologist’s report contained the following finding: “..... In the deeper regions, scar connective tissue can be seen, in which a foreign body is to be found in places, in the form of small black particles. Individual lymphocytes occur in the vicinity of these particles, but no appreciable inflammatory changes are visible, and no giant cell or granuloma formation can be observed”.Fig. 4

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